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[Sarcoidosis and progressive multifocal leukoencephalopathy].

M A Mackowiak-Cordoliani1, J De Seze, T Stojkovic

  • 1Clinique Neurologique, Hôpital Roger Salengro, CHRU Lille, 59037 Lille cedex.

Revue Neurologique
|July 5, 2001
PubMed
Summary

This case highlights a rare association between sarcoidosis and progressive multifocal leukoencephalopathy (PML). Early detection of JC virus (JCV) in cerebrospinal fluid is crucial when neurosarcoidosis is suspected but uncertain.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Sarcoidosis is a multisystem inflammatory disease that can affect the central nervous system (neurosarcoidosis).
  • Progressive multifocal leukoencephalopathy (PML) is a rare, demyelinating disease caused by the JC virus (JCV).

Observation:

  • A 70-year-old woman with sarcoidosis presented with progressive cognitive decline and gait disturbance.
  • Brain MRI showed a lesion initially suggestive of neurosarcoidosis, but rapid progression and cerebellar involvement raised suspicion for PML.
  • JC virus DNA was detected in cerebrospinal fluid via PCR.

Findings:

  • The patient's rapid neurological deterioration and MRI findings were consistent with PML.
  • Despite antiviral treatment, the patient succumbed to the illness nine months after symptom onset.

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Implications:

  • This case suggests a potential association between sarcoidosis and PML.
  • It underscores the importance of testing for JCV in cerebrospinal fluid when neurosarcoidosis diagnosis is uncertain to rule out PML.