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Progressive multifocal leukoencephalopathy in a patient without apparent immunosuppression
Authors:Jessie Grewal  Poorvi Dalal  Michelle Bowman  Behiye Kaya  José Javier Otero  Jaime Imitola
Institution:1.Department of Neurology,The Ohio State University Wexner Medical Center,Columbus,USA;2.Comprehensive Multiple Sclerosis Center,The Ohio State University Wexner Medical Center,Columbus,USA;3.Department of Pathology,The Ohio State University Wexner Medical Center,Columbus,USA;4.Laboratory for Neural Stem Cells and Functional Neurogenetics, Division of Neuroimmunology and Multiple Sclerosis,Ohio State University Wexner Medical Center,Columbus,USA
Abstract:Progressive multifocal leukoencephalopathy (PML) is a viral demyelinating disease due to the reactivation of the JC virus (JCV), which usually occurs in the context of immunosuppression in HIV infection, malignancy, or in patients on disease modifying therapy for autoimmune diseases, such as multiple sclerosis (MS) and Crohn’s disease. Notably, there is growing recognition that PML can occur in patients with transient immune dysfunction. Here, we present a case of a 55-year-old man without history of immunosuppression or evidence of ICL who was diagnosed with PML on brain biopsy. We will discuss the potential etiologies of mild and transient immunosuppression that can lead to PML with non-apparent immunosuppression.
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