Progressive Multifocal Leukoencephalopathy Localized in the Cerebellum and Brainstem Associated with Idiopathic CD4(+) T Lymphocytopenia.
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease that favors the cerebrum and typically occurs in immunosuppressed patients. We herein report the case of a 66-year-old man with PML, idiopathic CD4(+) T lymphocytopenia (ICL), and chronic renal failure. Cranial magnetic resonance imaging (MRI) showed a crescent-shaped lesion in the left cerebellum, brainstem, and middle cerebellar peduncle. Although the patient did not present with HIV infection, collagen diseases, or tumors, JC virus DNA was detected in the cerebrospinal fluid. Clinicians should consider PML and ICL in the differential diagnosis if the patient develops progressive ataxia and a crescent-shaped cerebellar lesion on MRI.
Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
Yuya
Y
Aotsuka
Akiyuki
A
Uzawa
Kazutaka
K
Nishimura
Kazuho
K
Kojima
Mika
M
Yamaguchi
Takahiro
T
Makino
Kazuo
K
Nakamichi
Masayuki
M
Saijo
Satoshi
S
Kuwabara
D000328:Adult; D000368:Aged; D001933:Brain Stem / Q000000981:diagnostic imaging* / Q000473:pathology; D002531:Cerebellum / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D007968:Leukoencephalopathy, Progressive Multifocal / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D008231:Lymphopenia / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged