Journal
JOURNAL OF THE NEUROLOGICAL SCIENCES
Volume 287, Issue 1-2, Pages 246-249Publisher
ELSEVIER
DOI: 10.1016/j.jns.2009.09.014
Keywords
Systemic lupus erythematosus; Progressive multifocal leukoencephalopathy; JC virus; Mycophenolate mofetil; Immune reconstitution inflammatory syndrome
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Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the central nervous system with JC virus. Few cases have been described in lupus patients. We describe biopsy-proven PML in a lupus patient receiving mycophenolate mofetil and corticosteroids. Although the patient received no antiviral treatment, the polymerase chain reaction test for JC virus became negative in cerebrospinal fluid after immunosuppressant discontinuation and the patient survived. We discuss the restoration of immune efficiency after immunosuppressant discontinuation in this case and compare the clinical, radiological and histological features with the inflammatory PML form described in human immunodeficiency virus-infected patients. (C) 2009 Elsevier B.V. All rights reserved.
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