Progressive Multifocal Leukoencephalopathy in a HIV Negative, Immunocompetent Patient
Author
Source
Case Reports in Neurological Medicine
Issue
Vol. 2016, Issue 2016 (31 Dec. 2016), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2016-07-27
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease most common in immunodeficient patients.
It occurs due to reactivation of the John Cunningham Virus (JCV) and carries a poor prognosis, with a median life expectancy of 6 months.
We report a case of a 66-year-old man with a history of HCV related cirrhosis (HCV) and hepatocellular carcinoma (HCC) who was found to have PML in the setting of a negative viral load in the CSF and a CD4+ >200.
He initially presented with two weeks of mild confusion and word-finding difficulty concerning for hepatic encephalopathy.
An MRI was notable for extensive T2/FLAIR hyperintensity signal in the left temporal lobe.
Brain biopsy was positive for JCV.
PML is rare in immunocompetent individuals, especially in the setting of a negative viral load.
It is possible, however, that transient states of immunosuppression may have been responsible in this case.
Although viral load was reported as negative, virus may still have been detected but was below the quantifiable threshold.
It is important for clinicians to note that a negative result does not necessarily exclude the possibility of PML, and care should be taken to review lab values on viral load in closer detail.
American Psychological Association (APA)
Nanda, T.. 2016. Progressive Multifocal Leukoencephalopathy in a HIV Negative, Immunocompetent Patient. Case Reports in Neurological Medicine،Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1101313
Modern Language Association (MLA)
Nanda, T.. Progressive Multifocal Leukoencephalopathy in a HIV Negative, Immunocompetent Patient. Case Reports in Neurological Medicine No. 2016 (2016), pp.1-4.
https://search.emarefa.net/detail/BIM-1101313
American Medical Association (AMA)
Nanda, T.. Progressive Multifocal Leukoencephalopathy in a HIV Negative, Immunocompetent Patient. Case Reports in Neurological Medicine. 2016. Vol. 2016, no. 2016, pp.1-4.
https://search.emarefa.net/detail/BIM-1101313
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1101313