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[Progressive multifocal leukoencephalopathy. Late complication in chronic lymphatic leukemia]
Deutsche Medizinische Wochenschrift (1946)
|June 12, 1987
Summary
Progressive multifocal leukoencephalopathy (PML) was diagnosed postmortem in a patient with chronic lymphatic leukemia and antibody deficiency. Autopsy revealed PML in brain regions showing NMR changes, with detected papova-like virions.
Area of Science:
- Neurology
- Oncology
- Virology
Background:
- A 44-year-old patient with chronic lymphatic leukemia (CLL) and secondary antibody deficiency syndrome presented with neurological deficits.
- The patient experienced a disorder of articulation and left hemiparesis during a thrombocytopenic phase.
Observation:
- Cranial computed tomography (CT), cerebrospinal fluid (CSF) diagnostics, and electroencephalogram (EEG) were inconclusive for the cause of rapidly progressive cerebral symptoms.
- Magnetic resonance imaging (NMR) revealed diffusely increasing intensity in T2-weighted images around the central region of the right brain.
Findings:
- The patient succumbed to Pseudomonas septicemia.
- Autopsy confirmed progressive multifocal leukoencephalopathy (PML) in the NMR-identified brain areas.
- Electron microscopy detected papova-like virions within glial cells, confirming JC virus infection.
Implications:
- This case highlights PML as a rare but severe complication in immunocompromised patients, particularly those with CLL and antibody deficiencies.
- Early recognition of subtle NMR findings may be crucial for diagnosing PML in similar clinical contexts.
- The presence of papova-like virions underscores the viral etiology of PML and its association with specific host immune statuses.