Progressive multifocal leukoencephalopathy in liver transplant recipients: a case report and review of the literature.

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the reactivation of the JC polyomavirus in immunocompromised patients. We report a case of PML in a liver transplant recipient and review the other published cases. The clinical course of PML is characterised by a rapid progressive neurological decline coinciding with the presence of white matter lesions on magnetic resonance images. There is no direct antiviral therapy available against the JC polyomavirus. Restoration of the immune response achieved by tapering or terminating the immunosuppressive regimen is the mainstay of treatment at present in transplanted patients. The prognosis remains, however, extremely poor regardless of treatment.