Background: Progressive multifocal leukoencephalopathy (PML) is a rare infectious cause of sub-acute neurological symptoms, and occurs predominantly in immunocompromised patients. PML is caused by reactivation of the JC virus.
Case Description: A 79-year-old man with a history of chronic B-cell lymphatic leukaemia (B-CLL) presented at our hospital with a neurological deficit of the left side of his body. He was initially diagnosed with a right-hemisphere stroke. Two months later he returned with progressive paresis and on an MRI of the brain we saw an increase in abnormalities of the white matter. On suspicion of PML we conducted PCR for JC virus on cerebrospinal fluid (CSF), which was negative. Histopathological investigations of a brain biopsy confirmed the diagnosis of PML, four months after he first presented.
Conclusion: PML is a rare cause of sub-acute neurological symptoms. PML can be difficult to diagnose as a PCR of CSF for JC virus in the early stages of PML can give a false negative result. If PML is suspected, histological investigation of a brain biopsy is necessary.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Diagnostic Insighhts Into JC Virus-Infected Glial Cells: Intraoperative Cytopathological Analysis of Dot-Shaped Inclusions Associated With PML-NBs.
Cytopathology
January 2025
Department of Pathology and Applied Neurobiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
This is the first case report describing the diagnostic value of dot-shaped inclusions associated with promyelocytic leukaemia nuclear bodies (PML-NBs) to define JC virus-infected glial cells in an intraoperative cytopathological diagnosis for progressive multifocal leukoencephalopathy (PML).
View Article and Find Full Text PDFPerformance of Ultrasensitive Polymerase Chain Reaction Testing for JC Polyomavirus in Cerebrospinal Fluid Compared with Pathological Diagnosis of Progressive Multifocal Leukoencephalopathy.
Viruses
December 2024
Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan.
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by the JC polyomavirus (JCPyV). Based on the clinical criteria, PML is diagnosed via polymerase chain reaction (PCR) detection of JCPyV DNA in cerebrospinal fluid (CSF) in combination with neurological and imaging findings. Although the utility of CSF JCPyV testing using ultrasensitive PCR assays has been suggested, its potential requires further evaluation.
View Article and Find Full Text PDFAnalysis of Immunological Memory for John Cunningham Virus in a Mexican Population of Patients with Multiple Sclerosis Under Treatment.
Biomedicines
November 2024
Virological Analysis and Reference Unit, National Medical Center "20 de Noviembre" Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03100, Mexico.
: Multiple sclerosis (MS) is a disease characterized by demyelination and axonal damage of the central nervous system. Despite the observed benefits, highly effective treatment (HET)-based therapy has adverse effects, which include an increased risk of developing progressive multifocal leukoencephalopathy (PML). Additionally, the risk grows if the patient has antibodies for the John Cunningham virus (JCV).
View Article and Find Full Text PDFDiagnosing progressive multifocal leukoencephalopathy: Positive predictive value of CSF JC virus quantitative PCR and importance of recognizing suggestive neuroimaging findings.
J Neurol Sci
January 2025
Department of Clinical Neurological Sciences, Western University, London Health Sciences Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London Health Sciences Centre, London, Ontario, Canada. Electronic address:
Objective: To determine the positive predictive value (PPV) of CSF John Cunningham virus (JCV) quantitative PCR (qPCR) for progressive multifocal leukoencephalopathy (PML), and highlight neuroimaging findings reported to be suggestive of this disease.
Methods: We reviewed patients at London Health Sciences Centre with a positive CSF JCV qPCR result. Patients were classified as true-positive if they had a clinico-radiographic presentation compatible with PML and no more likely alternative diagnosis.
Anti-JCV antibody index seroconversion in Turkish multiple sclerosis patients treated with natalizumab.
Neurol Sci
December 2024
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Background: The anti-JCV antibody index is widely used to monitor multiple sclerosis (MS) patients receiving natalizumab, as seroconversion is linked to an increased risk of progressive multifocal leukoencephalopathy. This study aimed to evaluate the prevalence and risk factors of anti-JCV antibody seroconversion in patients treated with natalizumab.
Methods: We included MS patients exposed to natalizumab treatment for at least one year, with a negative anti-JCV antibody index at baseline, and a minimum of two anti-JCV antibody assessments more than six months apart.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!