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Progressive multifocal leukoencephalopathy in a lung transplant recipient.
David Shitrit1, Lev Nirit, Sheely I Shiran
1Pulmonary Institute, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Petah Tivka, Israel.
Summary
Progressive multifocal leukoencephalopathy (PML) is a rare brain infection. This study details a lung transplant patient treated successfully for PML with antiviral therapy, highlighting its potential increase post-transplant.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, severe demyelinating disease of the central nervous system.
- PML is caused by the John Cunningham virus (JCV), a human polyomavirus.
- PML typically affects individuals with compromised immune systems, including transplant recipients.
Observation:
- A case of PML occurring 7 months post-lung transplantation is presented.
- The patient received immunosuppressive therapy modulation and cidofovir, an antiviral agent.
- Four additional cases of PML following heart and lung transplantation were identified in the literature.
Findings:
- Treatment with immunosuppressive modulation and cidofovir led to stabilization of PML symptoms in the described patient.
- The review of literature indicates a pattern of PML occurrence after solid organ transplantation, particularly heart and lung transplants.
- The incidence of PML may rise with the increasing number of heart and lung transplant recipients.
Implications:
- This case and literature review underscore the risk of PML in lung transplant recipients.
- Cidofovir shows potential as an antiviral therapy for managing PML in immunocompromised patients.
- Increased surveillance and awareness of PML are crucial in managing the growing population of solid organ transplant recipients.