Progressive multifocal leukoencephalopathy in a patient without apparent immunosuppression.
Progressive multifocal leukoencephalopathy (PML) is a viral demyelinating disease due to the reactivation of the JC virus (JCV), which usually occurs in the context of immunosuppression in HIV infection, malignancy, or in patients on disease modifying therapy for autoimmune diseases, such as multiple sclerosis (MS) and Crohn's disease. Notably, there is growing recognition that PML can occur in patients with transient immune dysfunction. Here, we present a case of a 55-year-old man without history of immunosuppression or evidence of ICL who was diagnosed with PML on brain biopsy. We will discuss the potential etiologies of mild and transient immunosuppression that can lead to PML with non-apparent immunosuppression.
Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Jessie
J
Grewal
Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Poorvi
P
Dalal
Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.|Comprehensive Multiple Sclerosis Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Michelle
M
Bowman
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Behiye
B
Kaya
Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
José Javier
JJ
Otero
Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. jaime.imitola@osumc.edu.|Comprehensive Multiple Sclerosis Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA. jaime.imitola@osumc.edu.|Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Neuroimmunology and Multiple Sclerosis, Ohio State University Wexner Medical Center, 460W12th Ave, Biomedical Research Tower, Room 688, Columbus, OH, 43321, USA. jaime.imitola@osumc.edu.
Jaime
J
Imitola
D001921:Brain / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology; D004172:Diplopia / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007121:Immunocompetence; D007577:JC Virus / Q000276:immunology / Q000302:isolation & purification; D007968:Leukoencephalopathy, Progressive Multifocal / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology; D014717:Vertigo / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology* / Q000821:virology
Immunocompetent host; Progressive multifocal leukoencephalopathy