title: Chlorpromazine combined with cidofovir for treatment of a patient suffering from progressive multifocal leukoencephalopathy.
abstract: 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.
authors.affiliation: Institut für medizinische Mikrobiologie und Hygiene, Dresden, Deutschland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Pöhlmann
authors.forename: Kristina
authors.initials: K
authors.lastname: Hochauf
authors.forename: Christoph
authors.initials: C
authors.lastname: Röllig
authors.forename: Johannes
authors.initials: J
authors.lastname: Schetelig
authors.forename: Olaf
authors.initials: O
authors.lastname: Wunderlich
authors.forename: Dirk
authors.initials: D
authors.lastname: Bandt
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Enno
authors.initials: E
authors.lastname: Jacobs
authors.forename: Jacques
authors.initials: J
authors.lastname: Rohayem
mesh_terms: 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*
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir; D002746:Chlorpromazine