AI Article Synopsis
- * Testing of cerebrospinal fluid revealed the presence of JC virus (JCV), which, along with biopsy results showing demyelinating lesions, confirmed the diagnosis of PML.
- * Treatment with high-dose corticosteroids, along with mefloquine and mirtazapine, improved the patient's condition, highlighting the importance of checking for HTLV-1 infection to understand this type of brain inflammation better.
Article Abstract
A middle-aged man with progressive multifocal leukoencephalopathy (PML) in a human T-cell lymphotropic virus type-1 (HTLV-1) carrier on haemodialysis presented with mild dysarthria and ataxia. Brain MRI revealed asymmetric T-hyperintense lesions in the cerebral white matter, cerebellum and brainstem. A small amount of JC virus (JCV) genome in cerebrospinal fluid was detected by PCR and cerebellar biopsy demonstrated JCV-DNA presence. Pathological findings showed demyelinating lesions and glial cells with mildly enlarged nuclei, accompanied by T-lymphocytes, neutrophils and plasma cell infiltration. The CD4+/CD8+ratio was 0.83. High-dose corticosteroid therapy was effective for inflammatory PML lesions, and the administration of mefloquine combined with mirtazapine led to favourable outcome. The encephalitis in this case is considered to have occurred secondarily to JCV infection in the presence of HTLV-1 infection. Therefore, it is crucial to investigate the presence of HTLV-1 in order to understand the aetiology of this brain inflammation.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11085685 | PMC |
| http://dx.doi.org/10.1136/bcr-2023-257805 | DOI Listing |
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