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Updated: May 13, 2026
Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
Published on: May 2, 2013
Progressive multifocal leukoencephalopathy in a heart transplant recipient following rituximab therapy for
R Y Loyaga-Rendon1, D O Taylor2, C E Koval3
1Section of Advanced Heart Failure and Transplantation, University of Alabama at Birmingham, AL.
Abstract:
We report the case of a male heart transplant recipient who developed acute antibody-mediated rejection and was treated with 5 weeks of a rituximab-containing regimen. Two months later he presented with progressive motor and cognitive impairments and was diagnosed with progressive multifocal leukoencephalopathy (PML). He was treated with reduction of his immunosuppressive medications, mirtazapine, IVIG and plasmapheresis. He died within weeks. We reviewed the current literature on PML and its association with immunosuppression, highlighting its impact in the setting of solid organ transplantation and considering the potential effect of newer biologic drugs on the incidence of this devastating disease in the transplant population.
Insights
A heart transplant patient treated with rituximab developed progressive multifocal leukoencephalopathy (PML), a rare brain infection. Despite treatment, the patient died, underscoring PML risks in immunosuppressed transplant recipients.
Area of Science:
- Neuroimmunology
- Transplant Medicine
- Infectious Diseases
Background:
- Solid organ transplant recipients require long-term immunosuppression to prevent rejection.
- Certain immunosuppressive agents, including newer biologics, may increase the risk of opportunistic infections.
- Progressive multifocal leukoencephalopathy (PML) is a rare, devastating demyelinating disease caused by the JC virus.
