Biopsy-proven PML in an HIV-negative patient with discoid lupus: Failure to detect JC virus in CSF.
Discoid lupus erythematosus
Polymerase chain reaction
Progressive multifocal leukoencephalopathy
cerebrospinal fluid
Journal
Clinical neurology and neurosurgery
ISSN: 1872-6968
Titre abrégé: Clin Neurol Neurosurg
Pays: Netherlands
ID NLM: 7502039
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
19
06
2021
revised:
15
07
2021
accepted:
21
07
2021
pubmed:
31
8
2021
medline:
5
3
2022
entrez:
30
8
2021
Statut:
ppublish
Résumé
We present a case of a 58-year-old man with a history of severe discoid lupus erythematosus and acute encephalopathy and incoordination. Antinuclear antibody testing was weakly positive but all other laboratory tests for systemic lupus erythematosus were negative and serum quantitative immunoglobulins and lymphocytes were normal. MRI brain showed T2/FLAIR hyperintensities within the bilateral parietal and temporal lobes with involvement of subcortical U fibers. CSF PCR was negative for varicella-zoster virus, herpes simplex, JCV and BK virus. However, JCV antibody index was elevated (3.88; reference: < 0.2). Right parietal brain biopsy was consistent with JCV infection and diagnostic of progressive multifocal leukoencephalopathy (PML). To the best of our knowledge, this is the first reported case of PML in a patient with discoid lupus without other traditional risk factors for the disease and highlights the need for clinical vigilance in this patient population.
Identifiants
pubmed: 34461360
pii: S0303-8467(21)00372-3
doi: 10.1016/j.clineuro.2021.106843
pmc: PMC10590808
mid: NIHMS1938028
pii:
doi:
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106843Subventions
Organisme : NHLBI NIH HHS
ID : R38 HL143605
Pays : United States
Organisme : NHLBI NIH HHS
ID : R38 HL167282
Pays : United States
Informations de copyright
Published by Elsevier B.V.
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