JC virus meningitis in a patient with systemic lupus erythematosus

Area of Science:

• Neurovirology
• Immunology
• Infectious Diseases

Background:

• JC virus (JCV) is a human neurotropic polyomavirus, typically acquired asymptomatically in childhood.
• In immunocompromised individuals, JCV can cause progressive multifocal leukoencephalopathy (PML).
• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems.

Observation:

• A patient with a history of systemic lupus erythematosus presented with acute meningitis.
• The patient did not exhibit signs of encephalitis or progressive multifocal leukoencephalopathy (PML).
• Cerebrospinal fluid analysis identified JC virus (JCV) as the sole pathogen.

Findings:

• JC virus (JCV) was identified as the causative agent of meningitis in an immunocompromised patient with systemic lupus erythematosus.
• This case suggests JCV can cause symptomatic meningitis, potentially through primary infection or reactivation, in the context of autoimmune disease.
• The absence of encephalitis or PML indicates a distinct clinical presentation of JCV infection.

Implications:

• JC virus (JCV) has a broader clinical spectrum than previously recognized, particularly in patients with autoimmune diseases.
• Diagnostic testing for JCV should be considered in the work-up of meningitis or encephalitis in patients with systemic lupus erythematosus and other autoimmune conditions.
• This finding underscores the expanding clinical significance of JCV in immunocompromised populations, especially those with underlying autoimmune disorders.