Mefloquine improved progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus.
We describe a case of a 67-year-old man with systemic lupus erythematosus who presented with progressive left hemiplegia. Although the cerebral spinal fluid (CSF) polymerase chain reaction (PCR) for the JC virus was negative, a brain biopsy confirmed the diagnosis of progressive multifocal leukoencephalopathy (PML). The tapering of prednisone and the use of cidofovir could not arrest the disease progression. Administration of mefloquine stopped the extension of the lesion, and resulted in obvious clinical improvement. The CSF nested PCR for the JC virus also became negative. This widely used drug should be tried for the treatment of non-HIV PML.
Department of Neurology, Kobe City Medical Center General Hospital, Japan. bepumi550@gmail.com
Minako
M
Beppu
Michi
M
Kawamoto
Souichi
S
Nukuzuma
Nobuo
N
Kohara
D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use*
D000962:Antimalarials; D004279:DNA, Viral; D015767:Mefloquine