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Undetectable JC virus CSF PCR in patients with JC virus-induced progressive multifocal leukoencephalopathy
Chia-Yu Chiu1, Eva Amenta2, Violeta Chavez3
1Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin St, STE MSB 2112, Houston, TX, USA. chia-yu.chiu@uth.tmc.edu.
Abstract:
The diagnosis of progressive multifocal leukoencephalopathy (PML) is based on a combination of clinical, radiographic, and laboratory findings. However, negative JC polyomavirus (JCPyV) PCR in CSF does not always rule out JCPyV-related PML. In this narrative review, we sought to examine the characteristic of biopsy-proven PML in patients with undetectable JCPyV CSF PCR and provide alternative approaches in this scenario.
Insights
Diagnosing progressive multifocal leukoencephalopathy (PML) can be challenging, as negative JC polyomavirus (JCPyV) PCR in cerebrospinal fluid (CSF) does not exclude JCPyV-related PML. This review explores biopsy-proven PML cases with undetectable JCPyV CSF PCR.
Area of Science:
- Neurovirology
- Neuropathology
- Diagnostic Imaging
Background:
- Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system.
- Diagnosis typically relies on clinical, radiographic, and laboratory findings, including JC polyomavirus (JCPyV) detection.
- Negative JCPyV PCR in cerebrospinal fluid (CSF) does not reliably exclude JCPyV-related PML.
Conclusions:
- JCPyV CSF PCR negativity should not preclude PML diagnosis.
- Biopsy-proven PML cases with undetectable JCPyV CSF PCR present distinct features.
- Alternative diagnostic strategies are crucial for accurate JCPyV-related PML diagnosis in such scenarios.
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