Mirtazapine in progressive multifocal leukoencephalopathy associated with polycythemia vera.
Progressive multifocal leukoencephalopathy (PML) is a usually fatal cerebral white matter disease found in patients with human immunodeficiency virus infection and other immunocompromised states. We present the case of a 63-year-old woman with polycythemia vera who developed a progressive focal neurological deficit with white matter abnormalities on magnetic resonance images of the brain that was proved on biopsy to be PML. She was treated with the serotonin reuptake inhibitor mirtazapine and remains neurologically stable, with resolution of cerebral lesions, >2 years after diagnosis. We propose that mirtazapine should be investigated further for use in PML.
Department of Neurology, Mount Sinai Medical Center, New York, NY 10029, USA.
Susama
S
Verma
Katia
K
Cikurel
Igor J
IJ
Koralnik
Susan
S
Morgello
Charlotte
C
Cunningham-Rundles
Zelig R
ZR
Weinstein
Christine
C
Bergmann
David M
DM
Simpson
D005260:Female; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D008803:Mianserin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D011087:Polycythemia Vera / Q000150:complications* / Q000473:pathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D008803:Mianserin; D000078785:Mirtazapine; D017367:Selective Serotonin Reuptake Inhibitors