期刊
NEUROLOGY INTERNATIONAL
卷 15, 期 3, 页码 917-925出版社
MDPI
DOI: 10.3390/neurolint15030059
关键词
progressive multifocal leukoencephalopathy; anti-Yo antibody; rapidly progressive cerebellar syndrome; systemic lupus erythematosus; cerebellar ataxia
This article reports a case of a 58-year-old woman with a history of systemic lupus erythematosus who presented with progressive gait disturbances. MRI and CSF examination revealed punctate lesions and rapidly progressive cerebellar syndrome. Further testing detected the presence of progressive multifocal leukoencephalopathy. Treatment led to stabilization of the patient's condition.
A 58-year-old woman with a history of systemic lupus erythematosus (SLE) who was taking prednisolone and mycophenolate mofetil presented with gait disturbances that progressively worsened over a period of 3 months. Her blood test and cerebrospinal fluid (CSF) examination results did not indicate active SLE. Initial brain magnetic resonance imaging (MRI) revealed a small spotty lesion in the left cerebellar peduncle. The clinical course was consistent with rapidly progressive cerebellar syndrome (RPCS), which sometimes involves neuronal antibodies. The line blot assay detected anti-Yo antibodies, but no malignancy was found. Immunohistological techniques using rat brain sections yielded a negative result for anti-Yo antibodies. The second MRI revealed a focal lesion and surrounding spotty lesion in the left cerebellar peduncle, which was consistent with the punctate pattern observed in progressive multifocal leukoencephalopathy (PML). The CSF JCV-DNA test indicated the presence of cerebellar PML. Immunosuppressants were reduced, and mefloquine and mirtazapine were initiated. After approximately 2 years and 1 month, the CSF JCV-DNA results became negative. Cerebellar PML may exhibit a clinical course that is consistent with RPCS. The punctate pattern should be recognized as an early manifestation of PML. The CSF JCV-DNA copy number may serve as a useful indicator of PML stabilization.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据