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Published on: January 21, 2021
Progressive multifocal leukoencephalopathy in an AIDS patient
Ming-Hsing Lee1, Yan-Zhong Chen, Lih-Shinn Wang
1Department of Pathology, Tzu-Chi University and Buddhist Tzu-Chi General Hospital, Hualien, Taiwan.
Summary
Progressive multifocal leukoencephalopathy (PML), a brain disease caused by Jamestown Canyon virus (JCV), is a significant concern in AIDS patients. This case highlights PML
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a demyelinating brain disease.
- It is a significant cause of morbidity and mortality in acquired immunodeficiency syndrome (AIDS) patients.
- Jamestown Canyon virus (JCV) is the causative agent of PML.
Observation:
- A 34-year-old HIV-1 infected male presented with seizures and left-sided weakness.
- Clinical and MRI findings were consistent with PML.
- The patient died of sepsis two months post-diagnosis.
Findings:
- Autopsy confirmed PML with characteristic histopathology: multifocal demyelination, bizarre astrocytes, and intranuclear inclusion bodies in oligodendrocytes.
- In situ hybridization detected the JCV genome within oligodendrocyte nuclei.
- Neurologic signs and MRI findings in AIDS patients with demyelination suggest PML.
Implications:
- Early clinical diagnosis of PML is crucial in AIDS patients presenting with neurological symptoms and characteristic MRI findings.
- Understanding PML pathogenesis in immunocompromised individuals is vital for patient outcomes.
- This case underscores the importance of considering opportunistic infections in HIV-1 positive individuals.
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