title: Inflammatory infratentorial progressive multifocal leukoencephalopathy in a patient with rheumatoid arthritis.
abstract: An 84-year-old man with rheumatoid arthritis (RA) treated with methotrexate, developed progressive confusion and cerebellar symptoms, and died approximately 2 months later. Neuropathological examination revealed progressive multifocal leukoencephalopathy (PML) involving the cerebellum and brainstem. The affected tissues displayed intense infiltrations by CD8+ T-cells and microglia. JC virus was localized in oligodendroglia and cerebellar granule cells. This case illustrates unusual localization of inflammatory PML in a patient with RA treated with methotrexate.
authors.affiliation: Department of Pathology & Molecular Medicine, McMaster University, Hamilton Health Sciences, Hamilton General Hospital (Neuropathology), Hamilton, Ontario, Canada.
authors.forename: Boleslaw
authors.initials: B
authors.lastname: Lach
authors.forename: Barbara
authors.initials: B
authors.lastname: Connolly
authors.forename: Christian
authors.initials: C
authors.lastname: Wüthrich
authors.forename: Igor J
authors.initials: IJ
authors.lastname: Koralnik
mesh_terms: D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002531:Cerebellum / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications / Q000473:pathology*; D008297:Male; D011149:Pons / Q000473:pathology
keywords: cerebellar syndrome; demyelination; methotrexate; progressive multifocal leukoencephalopathy; rheumatoid arthritis