Journal
INTERNAL MEDICINE
Volume 56, Issue 10, Pages 1231-1234Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.56.7689
Keywords
progressive multifocal leukoencephalopathy; JC virus; DNA test; brain biopsy; demyelination; slow virus infection
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Funding
- Research Committee of Prion Disease and Slow Virus Infection
- Research on Policy Planning and Evaluation of Rare and Intractable Diseases from the Ministry of Health, Labour and Welfare of Japan
- Research Committee of Molecular Pathogenesis and Therapies for Prion Disease and Slow Virus Infection
- Practical Research Project for Rare/Intractable Disease from Japan Agency for Medical Research and Development, AMED
- Grants-in-Aid for Scientific Research [26860270] Funding Source: KAKEN
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The current standard diagnostic approach for progressive multifocal leukoencephalopathy (PML) is to perform a DNA test to identify the presence of the JC virus in cerebrospinal fluid (CSF). A 32-year-old woman with a 5-year history of systemic lupus erythematosus developed right hemiplegia and motor aphasia. MRI revealed a large white matter lesion in the left frontal lobe. JC virus DNA was undetectable in the CSF, but a brain biopsy showed typical histopathology and a high DNA load of the JC virus. The patient was treated with mefloquine and mirtazapine, and is currently alive at 24 months after onset. An early brain biopsy may therefore be important for making a timely diagnosis of PML.
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