Chlorpromazine combined with cidofovir for treatment of a patient suffering from progressive multifocal leukoencephalopathy.
We report on a stem cell-transplanted patient with B cell chronic lymphatic leukemia who presented with a subacute onset of focal neurological deficits, gait abnormalities, emotional lability and dementia. Progressive multifocal leukoencephalopathy was diagnosed by magnetic resonance imaging (MRI) of the brain and detection of JC virus genome in the cerebrospinal fluid. Cidofovir and the 5HT2A receptor antagonist chlorpromazine were subsequently administered. A follow-up MRI of the brain 2 weeks after initiation of the antiviral therapy displayed progress of the demyelination, and the patient died 3 months after onset of the neurological symptoms. This report highlights the need for the development of novel and potent strategies for treatment of progressive multifocal leukoencephalopathy.
Pöhlmann
Christoph
C
Institut für medizinische Mikrobiologie und Hygiene, Dresden, Deutschland.
Hochauf
Kristina
K
Röllig
Christoph
C
Schetelig
Johannes
J
Wunderlich
Olaf
O
Bandt
Dirk
D
Ehninger
Gerhard
G
Jacobs
Enno
E
Rohayem
Jacques
J
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000998:Antiviral Agents / Q000008:administration & dosage*; D001921:Brain / Q000187:drug effects* / Q000473:pathology / Q000821:virology; D002746:Chlorpromazine / Q000008:administration & dosage*; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage*
D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir; D002746:Chlorpromazine