Journal
INTERNAL MEDICINE
Volume 51, Issue 10, Pages 1245-1247Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.51.6810
Keywords
progressive multifocal leukoencephalopathy; systemic lupus erythematosus; mefloquine
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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.
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