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Paradoxical Progressive Multifocal Leukoencephalopathy With Immune Reconstitution Inflammatory Syndrome in a Patient

Ibtisam A Ibrahim1,2, Priscila Lopez1,2, Vel Sivapalan1,2

  • 1Infectious Diseases, NYC Health + Hospitals/Harlem, New York, USA.

Cureus
|October 23, 2025
PubMed

Insights

This case study highlights managing paradoxical Progressive Multifocal Leukoencephalopathy (PML) and Immune Reconstitution Inflammatory Syndrome (IRIS) in an AIDS patient restarting antiretroviral therapy (ART). Prompt treatment with steroids and ART led to significant patient improvement.

Area of Science:

  • Neuroimmunology
  • Infectious Diseases
  • Neurology

Background:

  • Progressive Multifocal Leukoencephalopathy (PML) is a rare, fatal CNS demyelinating disease caused by John Cunningham Virus (JCV) reactivation.
  • PML predominantly affects immunocompromised individuals, particularly those with Acquired Immunodeficiency Syndrome (AIDS).
  • Immune Reconstitution Inflammatory Syndrome (IRIS) can paradoxically occur during antiretroviral therapy (ART) in patients with compromised immunity.

Keywords:
demyelinating central nervous system (cns) diseasehaart resumptionimmune reconstitution inflammatory syndrome (iris)john cunningham virus (jcv)progressive multifocal leukoencephalopathy (pml)

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