Progressive multifocal leukoencephalopathy in myelodysplastic syndrome involving pure red cell aplasia.
Progressive multifocal leukoencephalopathy (PML) is a rare and fatal demyelinating disease of the central nervous system caused by JC polyomavirus (JCV) reactivation in an immunocompromised host. We describe a case of PML in a 76-year-old woman with myelodysplastic syndrome, who had been treated with azathioprine for a pure red cell aplasia-like condition. PML was diagnosed based on the neurologic symptoms, the magnetic resonance imaging patterns and the detection of JCV DNA in the cerebrospinal fluid. She died ten months after the diagnosis. An autopsy confirmed the diagnosis, and JCV DNA was detected in the cerebrum. Azathioprine might have triggered PML.
Division of Hematology and Immunology, Department of Internal Medicine, Ohtsu Red Cross Hospital, Ohtsu.
Dai
D
Chihara
Tomoharu
T
Takeoka
Tomoyuki
T
Shirase
Wataru
W
Kishimoto
Kazue
K
Arimoto-Miyamoto
Masaaki
M
Tsuji
Tatsuharu
T
Ohno
D000368:Aged; D001379:Azathioprine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications / Q000175:diagnosis*; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis*; D012010:Red-Cell Aplasia, Pure / Q000150:complications / Q000175:diagnosis*
D007166:Immunosuppressive Agents; D001379:Azathioprine