A report of seven cases of progressive multifocal leukoencephalopathy in patients with acquired immune deficiency syndrome.
- Author:
Dong Myoung KWAK
1
;
Hyunil JEONG
;
Sang Min PARK
;
Hyuck Hwan CHA
;
Ja Yong JUNG
;
Ji Hwan BANG
;
Hyoung Shik SHIN
Author Information
1. Department of Internal Medicine, National Medical Center, Seoul, Korea. hsskdl@naver.com
- Publication Type:Case Report
- Keywords:
AIDS;
HIV;
JC virus;
Progressive multifocal leukoencephalopathy
- MeSH:
Acquired Immunodeficiency Syndrome;
Antiretroviral Therapy, Highly Active;
Brain;
CD4 Lymphocyte Count;
Central Nervous System Infections;
Communicable Diseases;
Disease Progression;
Female;
HIV;
Humans;
JC Virus;
Leukoencephalopathy, Progressive Multifocal;
Magnetic Resonance Spectroscopy;
Male;
Neurologic Examination;
Opportunistic Infections;
Temporal Lobe
- From:Korean Journal of Medicine
2010;78(6):771-775
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Secondary opportunistic central nervous system infections occur in approximately one-third of patients with acquired immune deficiency syndrome. With the introduction of highly active antiretroviral therapy, the number of opportunistic infection cases has significantly decreased. However, the number of progressive multifocal leukoencephalopathy (PML) cases caused by opportunistic human JC polyomavirus has not decreased at a noticeable rate. In this report, seven patients with PML were evaluated at the infectious disease unit of the National Medical Center. Six of the 7 patients were not on antiretroviral therapy at the time of diagnosis. The mean patient age of the 6 men and 1 woman was 39 years. The individual CD4 cell counts were 58, 6, 18, 73, 90, 252, and 94 cells/microliter. The mean CD4 cell count was 84 cells/microliter. The most common clinical manifestation was focal weakness and the temporal lobe was mainly involved. Two of the patients died 52 days after the diagnosis was made. Three patients survived for more than 1 year without disease progression. We conclude that one must take a careful patient history, perform a neurological examination, and examine brain magnetic resonance images in patients with human immunodeficiency virus who show neurological symptoms.
