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[Progressive multifocal leukoencephalopathy in a female patient with chronic lymphatic leukemia]
J Heikens1, W van Berkel, R A de Vos
1Medisch Spectrum Twente, Ziekenhuis Enschede, afd. Inwendige Geneeskunde.
Abstract:
This case report describes a 78-year old female patient with chronic lymphocytic leukaemia and neurological symptoms due to progressive multifocal leukoencephalopathy (PML). At autopsy the histopathology was characteristic, the involvement of JC virus was established. PML occurs in immunocompromised patients and is caused by infection with JC papova virus. Epidemiology, clinical course, diagnostic procedures with special reference to the use of the polymerase chain reaction, and therapy are briefly reviewed.
Insights
This case report details a patient with chronic lymphocytic leukemia who developed neurological symptoms from progressive multifocal leukoencephalopathy (PML), confirmed by autopsy and JC virus detection.
Area of Science:
- Neurology
- Virology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that can compromise immune function.
- Immunocompromised states increase susceptibility to opportunistic infections, including rare viral central nervous system diseases.
- Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the brain caused by the JC virus.
Observation:
- A 78-year-old female patient with a history of CLL presented with neurological deficits.
- Autopsy revealed characteristic histopathological findings consistent with PML.
- JC virus (a papova virus) was identified as the causative agent.
Findings:
- The patient's neurological symptoms were attributed to PML, a JC virus infection.
- Histopathology confirmed demyelination and characteristic viral inclusions.
- The case highlights the link between CLL-induced immunosuppression and PML development.
Implications:
- PML is a serious complication in immunocompromised individuals, particularly those with hematologic malignancies like CLL.
- Early diagnosis and understanding of PML pathogenesis are crucial for patient management.
- This case underscores the importance of considering opportunistic infections in the differential diagnosis of neurological symptoms in immunocompromised patients.