Progressive multifocal leukoencephalopathy, a review and an extended report of five patients with different immune compromised states

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Abstract

Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the brain caused by the X-virus. Both a decreased cellular or humoral immune response can increase the susceptibility for JC-virus induced PML. Not only HIV infected people are at risk, a wide range of otherwise immune compromised patients are a potential target for this virus. This report of five PML patients shows the importance of a clinician's familiarity with this disease and it's presenting symptoms. The presenting symptoms of PML can sometimes mimic worsening of the underlying disease. Although different therapeutic strategies have been tried, the outcomes remain very poor. In this series, treatment with cidofovir appears not to be effective in treating PML, neither in HIV positive nor HIV negative patients. Experimental therapy with leflunomide, after tapering of the immunosuppressive medication, did change the natural course of PML in one patient. (C) 2008 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)261-267
Number of pages7
JournalEuropean Journal of Internal Medicine
Volume20
Issue number3
DOIs
Publication statusPublished - 2009

Research programs

  • EMC MM-02-72-01
  • EMC MM-04-39-05
  • EMC OR-01-34-01

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