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Sunday 1 January 2012

Progressive multifocal leukoencephalopathy (PML)

-infection of oligodendrocytes by JC virus (a polyomavirus)
- characterised by progressive damage or inflammation of white matter at multiple locations
- occurs almost exclusively in immunosuppressed individuals
- presents with focal neurological deficits such as aphasia, hemiparesis, behavioural changes and cortical blindness.
- MRI: multifocal non enhancing lesions without mass effects
- viral PCR for JC virus
- brain biopsy (asymmetric foci of demyelination and intranuclear inclusion containing JC virus) has sensitivity of 74-92% and specificity of 92-100%
- no effective treatment but progression can be slowed by initiation of antiretroviral therapy

4 comments:

MMR said...

another Polyoma virus is BK Virus. responsible for Kidney Transplant Acute Rejection.

KIM, ALEX said...

Treatment for BK virus infection in patient with renal transplant is by reduction of immunosuppression

John said...

Hi. I was wondering how do you spot this on an MRI? Is the PML caused damage shows up as a white area on the MRI? I was also wondering where I could find some good medical article about progressive multifocal leukoencephalopathy treatment?

Thanks.

melody said...

PML shows hyperintense white matter lesions in T2 weighted MRI.