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Progressive Multifocal Leukoencephalopathy in a Chemotherapy-Naive Patient With Chronic Lymphocytic Leukemia: A Case Report.

Progressive multifocal leukoencephalopathy is a rare, progressive demyelinating disease of the central nervous system caused by reactivation and replication of the John Cunningham (JC) virus in cerebral oligodendrocytes. The JC virus is a small ubiquitous polyomavirus that can be detected in up to 50% of the adult population. It affects almost exclusively immunocompromised patients and is generally observed in patients with acquired immunodeficiency syndrome and patients with hematologic malignancies and autoimmune or chronic inflammatory diseases medicated with immunosuppressive and immunomod…

Progressive multifocal leukoencephalopathy in a patient treated with etanercept.

INTRODUCTION: Recently, increased attention has been paid to the association of progressive multifocal leukoencephalopathy (PML) with the us … tter without mass effect or gadolinium enhancement. Cerebrospinal fluid showed elevated protein and JC virus polymerase chain reaction positive with 28,600 copies/ml diagnostic of PML. CONCLUSIONS: The development of PML in this patient treated with etanercept and prednisone highlights the increased risk for opportunistic infection with JC virus in patien …

JC Polyomavirus Uses Extracellular Vesicles To Infect Target Cells.

The endemic human JC polyomavirus (JCPyV) causes progressive multifocal leukoencephalopathy in immune-suppressed patients. The mechanisms of virus infection in vivo are not understood because the major target cells for virus in the brain do not express virus receptors and do not bind virus. We found that JCPyV associates with extracellular vesicles (EVs) and can infect target cells independently of virus receptors. Virus particles were found packaged inside extracellular vesicles and attached to the outer side of vesicles. Anti-JCPyV antisera reduced infection by purified virus but had no effe

Progressive neurologic dysfunction in a psoriasis patient treated with dimethyl fumarate.

Progressive multifocal leukoencephalopathy (PML) has recently been described in psoriasis or multiple sclerosis patients treated with fumaric acid esters (fumarates), who had developed severe and long-standing lymphocytopenia (<500/mm(3) ). We report a psoriasis patient who presented with progressive neurologic dysfunction and seizures after 2.5 years of fumarate therapy. Despite absolute lymphocyte counts remaining between 500-1000/mm(3) , his CD4(+) and CD8(+) T-cell counts were markedly low. MRI showed right hemispheric and brainstem lesions and JC virus DNA was undetectable in his cerebros…

A comparison of human papovavirus T antigens.

A comparison was made of the T antigens induced in transformed cells or infected permissive cells by representatives of three categories of … ived strains, BK and RF, were identical or nearly so, but were clearly separable from T antigens of JC virus, PML-derived SV40 or simian-derived SV40. JC T antigen was intermediate, being more closely related to T antigens both of BK virus and SV40 virus than the latter were to each other. The T antigen of PML-derived SV40 could be distinguished from the T …

Morphological and virological investigations of cell strains cultured from the brain in Jakob-Creutzfeldt disease and subacute sclerosing panencephalitis.

Cell strains were established in culture from fragments of the brain from 2 cases each of Jakob-Creutzfeldt (JC) disease and subacute sclerosing panencephalitis (SSPE). After about 12 weeks strains from the former spontaneously formed persistent heaped up nodules of cells which appeared to produce reticulin-like fibrils as well as confluent sheets of rounded and spindle, fibroblast-like cells. Similar sheets of cells were obtained from the cases of SSPE but the only nodules formed were smaller and ephemeral. Attempts to detect virus in all 4 strains were made by inoculation of supernatant flui

[Progressive multifocal leukoencephalopathy under natalizumab. Initial possibilities for risk stratification?].

Natalizumab (Tysabri®) is the first monoclonal antibody approved for the treatment of relapsing forms of multiple sclerosis (MS) but while treatment is highly efficient, it carries the risk of progressive multifocal leukoencephalopathy (PML). Based on reports of confirmed cases of PML, the risk of PML might increase beyond 24 months of treatment. Thus, attempts to stratify patients treated with natalizumab into those carrying higher or lower risk for developing PML are currently being undertaken. Among these strategies JC virus serology might potentially be the first tool available. As a large…

Борьба с инфекциями со стороны полиомавируса человека: прошлое, настоящее и будущее.

Прогрессивная многофукальная лейкоэнцефалопатия — это смертельное демиелинизирующее заболевание, вызванное инфекцией олигодендроцитов человеческим полиомавирусом, известным как вирус JC. За последние 10 лет эта болезнь была задокументирована почти исключительно у больных СПИДом, которые составляют быстро растущую группу лиц, страдающих иммунодепрессией. В последнее время в результате иммуносупрессивной терапии пациенты, проходящие трансплантацию твердого органа или клеток, также описывают прогрессивную многофукальную лейкоэнцефалопатию. Несмотря на ряд сообщений об успешном лечении прогрессивн

Совпадение в аннотации оригинала
Progressive multifocal leukoencephalopathy is a fatal demyelinating disease caused by infection of oligodendrocytes by the human polyomavirus known as JC virus. Over the past 10 years, the disease has been documented almost exclusively in AIDS patients, who constitute a rapidly growing population of immunosuppressed individuals. More recently, progressive mu…

Progressive multifocal leukoencephalopathy: a burnt-out case.

A patient with Hodgkin's disease developed progressive multifocal leukoencephalopathy (PML), documented by brain biopsy to be associated with JC virus infection. His disease progressed over several months, resulting in severe neurological deficit, but then stabilized with little or no further clinical progression during the remaining year of his life. Histopathological evaluation of the brain at autopsy supported the clinical impression that brain infection was arrested. Whereas the brain biopsy exhibited the histological features of active PML including giant bizarre astrocytes, at postmortem…

[The detection of viral nucleic acid sequences in paraffin-embedded subacute sclerosing panencephalitis (SSPE) and progressive multifocal leukoencephalopathy (PML) brain tissues by in situ hybridization].

We have been able to detect the viral nucleic acid sequences in formalin-fixed paraffin embedded tissue sections of the brain from SSPE and PML respectively by in situ hybridization using cloned and radiolabelled complementary DNA (cDNA) measles nucleocapsid (NP) and JC virus probes which are gene specific respectively. We have mainly followed in situ hybridization procedure reported by Haase et al, but partly modified the technique including the extensive wash by buffer solution and the elevated concentration of proteinase K. Firstly, to compare with the number of hybridized cells and grain c…

Progressive multifocal leukoencephalopathy presenting with acute sensorineural hearing loss in an intestinal transplant recipient.

A 20-year-old male presented 3.5 years after intestinal transplantation with rapidly progressive sensorineural hearing loss. Initial brain imaging was consistent with inflammation and/or demyelination. Lumbar puncture was initially non-diagnostic and a broad infectious workup was unrevealing. Three months after presentation, a repeat LP detected JC virus for which tests had not earlier been conducted. He continued to deteriorate despite withdrawal of prior immunosuppression and addition of mirtazapine, maraviroc, and steroids. He died of progressive neurologic decompensation 5 months after his…

Последние достижения в лечении множественного склероза: эффективность, риски и место в терапии.

Разработка новых фармакологических агентов для лечения множественных склерозов (МС) и прогресс в области тестирования на воздействие вируса ОК привели к изменениям в лечении НР. Кроме того, несколько новых агентов находятся на поздней стадии разработки НР, и их выход на рынок обеспечит дополнительные варианты обработки. В 2012 году и в начале 2013 года как terifunomide, так и BG-12 будут, по всей вероятности, утверждены Администрацией Соединенных Штатов по контролю за продуктами питания и лекарственными препаратами (DFA) для лечения повторных форм MS. Терапевтическая среда уже изменилась и в б

Совпадение в аннотации оригинала
The development of new pharmacologic agents for the treatment of multiple sclerosis (MS) and advances in testing for exposure to the JC virus have led to changes in the treatment of MS. In addition several new agents are in late stage development for MS and their entry onto the market will provide additional treatment options. In 2012 and in early 2013, it i…

Progressive Multifocal Leukoencephalopathy.

Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection that occurs in patients whose immune system is compromised either because of an underlying illness or an immunosuppressive medication. John Cunningham virus, prevalent in 60% or more of the adult population as a latent or persistent infection, is responsible for the syndrome of PML. This article reviews PML in association with the most common immunotherapies and discusses risk mitigation and monitoring strategies.

Immunology of progressive multifocal leukoencephalopathy.

The high prevalence of asymptomatic JC polyomavirus (JCV) infection in the general population indicates coexistence with the human host and efficient immune control in healthy individuals. For unknown reasons, kidney-resident archetypic JCV strains can turn into neurotropic JCV strains which in hereditary or acquired states of immunodeficiency cause opportunistic infection and cytolytic destruction of glial cells or granule cell neurons resulting in progressive multifocal demyelination in the central nervous system (CNS) or cerebellar atrophy, respectively. Immunomodulatory or immunosuppressiv

Atypical Presentation of a Patient With Progressive Multifocal Leukoencephalopathy.

Progressive multifocal leukoencephalopathy (PML) is a rare, demyelinating infectious disease of the central nervous system, primarily affecting immunosuppressed individuals, such as those with acquired immunodeficiency syndrome (AIDS) or undergoing immunosuppressive therapy. The causative agent is the dormant John Cunningham (JC) polyomavirus, which reactivates in immunocompromised patients. PML is diagnosed through clinical observations, imaging, and polymerase chain reaction (PCR) analysis, detecting JC virus deoxyribonucleic acid (DNA) in the cerebrospinal fluid (CSF). Here, we report a cas…

[Progressive multifocal leukoencephalopathy an chronic lymphocytic leukemia].

INTRODUCTION: Progressive multifocal leukoencephalopathy is a demyelinating disease resulting from an opportunistic infection of the central nervous system by JC papovavirus. It mostly occurs in patients with an underlying immunosuppressive disorder. In the era of acquired immunodeficiency syndrome it is observed with increasing frequency. EXEGESIS: We report the case of a non-HIV-infected patient who presented chronic lymphocytic leukemia with progressive multifocal leukoencephalopathy uncovered by both imaging and the presence of JC virus in the cerebrospinal fluid. CONCLUSION: Due to the …

Single-center experience on progressive multifocal leukoencephalopathy (PML) cases, neuroimaging relevance, and management at West Virginia University (WVU).

Progressive multifocal leukoencephalopathy (PML) is an increasingly common and rapidly fatal demyelinating infection of central nervous system caused by the highly prevalent John Cunningham (JC) virus in immunocompromised individuals belonging to all age groups and genders. Human immunodeficiency virus (HIV) is the most common predisposing factor among other immunodeficient conditions leading to reactivation and multiple neurological symptoms. It has varied findings on magnetic resonance imaging (MRI) and diagnosis is confirmed by positive JC virus in cerebrospinal fluid (CSF). We report 12 co…

Failure of mefloquine therapy in progressive multifocal leukoencephalopathy: report of two Japanese patients without human immunodeficiency virus infection.

Although progressive multifocal leukoencephalopathy (PML) cases showing responses to mefloquine therapy have been reported, the efficacy of mefloquine for PML remains unclear. We report on the failure of mefloquine therapy in two Japanese patients with PML unrelated to human immunodeficiency virus. One of the patients was a 47-year-old male who had been treated with chemotherapy for Waldenström macroglobulinemia, and the other was an 81-year-old male with idiopathic CD4(+) lymphocytopenia. Diagnosis of PML was established based on MRI findings and increased JC virus DNA in the cerebrospinal fl…

Progressive multifocal leukoencephalopathy in two psoriasis patients treated with efalizumab.

Progressive multifocal leukoencephalopathy (PML) is a rare neurological disorder that occurs almost exclusively in immunocompromised individuals by reactivation of the John Cunningham virus (JC virus), a polyomavirus found latent in more than 80 percent of healthy adults. Efalizumab, an immunosuppressive monoclonal antibody targeting T cells, has been used for treatment of moderate-to-severe chronic psoriasis. The authors describe two cases of PML that occurred in patients < or = 70 years old treated with efalizumab for more than three years. Both presented with symptoms resembling cerebral in…

Progressive Multifocal Leukoencephalopathy Mimicking Stroke in a Patient With Newly Diagnosed HIV: A Case Report.

Progressive multifocal leukoencephalopathy (PML) is a rare but often fatal demyelinating disease of the central nervous system (CNS) caused … unrecognized HIV infection. Subsequent cerebrospinal fluid (CSF) analysis confirmed the presence of JC virus, establishing the diagnosis of progressive multifocal leukoencephalopathy. Despite prompt initiation of antiretroviral therapy, the patient further deteriorated, culminating in death. This case highlights the diagnostic complexity of PML and the imp …