medigraphic.com
Instituto Nacional de Neurología y Neurocirugía

2021, Número 4

<< Anterior Siguiente >>

Arch Neurocien 2021; 26 (4)


Leucoencefalopatía multifocal progresiva con afectación cerebelosa aislada

Gutiérrez-Romero A, Montenegro-Rosales A, Eguiluz-Melendez A, Rangel-Frausto M, Torruco-Sotelo C, Lanz-Zubiria L

Idioma: Español
Referencias bibliográficas: 29
Paginas: 43-49
Archivo PDF: 455.80 Kb.


RESUMEN

La leucoencefalopatía multifocal progresiva (LMP) representa una infección oportunista del sistema nervioso central ocasionada por el virus JC. Esta entidad puede aparecer en diversas patologías en huéspedes inmunosuprimidos, principalmente en pacientes con VIH/SIDA, sin embargo, hasta 3% de los casos pueden presentarse en personas inmunocompetentes. En los casos en los que la enfermedad se presenta en pacientes inmunosuprimidos, puede deberse a dos circunstancias: la primera, a la ausencia de tratamiento para la patología primaria, en este caso VIH, y la segunda, como parte de un síndrome de reconstitución inmunológica (SRI) posterior al inicio de la terapia antirretroviral. La importancia fundamental entre estas dos circunstancias es el tratamiento. Mientras que los pacientes que se encuentran sin antirretrovirales se ven beneficiados del inicio de dichos fármacos, los pacientes con SRI se benefician del uso de corticosteroides. El diagnóstico de LMP definitivo es histopatológico, en donde clásicamente se presenta la tríada de desmielinización, astrocitos atípicos y cuerpos de inclusión nucleares en los oligodendrocitos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Kartau M, Sipilä JO, Auvinen E, Palomäki M, Verkkoniemi- Ahola A. Progressive Multifocal Leukoencephalopathy: Current Insights. Degener Neurol Neuromuscul Dis. 2019; 9: 109–121.

  2. Pietropaolo V, Prezioso C, Bagnato F, Antonelli G. John Cunningham virus: an overview on biology and disease of the etiological agent of the progressive multifocal leukoencephalopathy. New Microbiol. 2018; 41: 179–186.

  3. Astrom KE, Mancall EL, Richardson EP. Progressive multifocal leuko-encephalopathy; a hitherto unrecognized complication of chronic lymphatic leukaemia and Hodgkin’s disease. Brain J Neurol. 1958; 81: 93–111.

  4. Padgett BL, Walker DL, ZuRhein GM, Eckroade RJ, Dessel BH. Cultivation of papova-like virus from human brain with progressive multifocal leucoencephalopathy. Lancet Lond Engl 1971; 1: 1257–1260.

  5. Fournier A, Martin-Blondel G, Lechapt-Zalcman E, Dina J, Kazemi A, Verdon R et al. Immune Reconstitution Inflammatory Syndrome Unmasking or Worsening AIDS-Related Progressive Multifocal Leukoencephalopathy: A Literature Review. Front Immunol 2017; 8: 577.

  6. Ferenczy MW, Marshall LJ, Nelson CDS, Atwood WJ, Nath A, Khalili K et al. Molecular biology, epidemiology, and pathogenesis of progressive multifocal leukoencephalopathy, the JC virus-induced demyelinating disease of the human brain. Clin Microbiol Rev. 2012; 25: 471–506.

  7. Auer M, Hegen H, Sellner J, Oppermann K, Bsteh G, Di Pauli F et al. Conversion and reversion of anti-John Cunningham virus antibody serostatus: A prospective study. Brain Behav. 2019; 9: e01332.

  8. Atkinson AL, Atwood WJ. Fifty Years of JC Polyomavirus: A Brief Overview and Remaining Questions. Viruses. 2020; 12: E969.

  9. Bellizzi A, Nardis C, Anzivino E, Rodìo DM, Fioriti D, Mischitelli M et al. Human polyomavirus JC reactivation and pathogenetic mechanisms of progressive multifocal leukoencephalopathy and cancer in the era of monoclonal antibody therapies. J Neurovirol. 2012; 18: 1–11.

  10. Gasnault J, Costagliola D, Hendel-Chavez H, Dulioust A, Pakianather S, Mazet A-A et al. Improved survival of HIV-1- infected patients with progressive multifocal leukoencephalopathy receiving early 5-drug combination antiretroviral therapy. PloS One 2011; 6: e20967.

  11. Anand P, Hotan GC, Vogel A, Venna N, Mateen FJ. Progressive multifocal leukoencephalopathy: A 25-year retrospective cohort study. Neurol Neuroimmunol Neuroinflammation. 2019; 6: e618.

  12. Tan K, Roda R, Ostrow L, McArthur J, Nath A. PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids. Neurology. 2009; 72: 1458–1464.

  13. Carson KR, Focosi D, Major EO, Petrini M, Richey EA, West DP et al. Monoclonal antibody-associated progressive multifocal leucoencephalopathy in patients treated with rituximab, natalizumab, and efalizumab: a Review from the Research on Adverse Drug Events and Reports (RADAR) Project. Lancet Oncol 2009; 10: 816–824.

  14. Iacobaeus E, Burkill S, Bahmanyar S, Hakim R, Byström C, Fored M et al. The national incidence of PML in Sweden, 1988-2013. Neurology. 2018; 90: e498–e506.

  15. 15 Sipilä JOT, Soilu-Hänninen M, Rautava P, Kytö V. Progressive multifocal leukoencephalopathy in Finland: a cross-sectional registry study. J Neurol. 2019; 266: 515–521.

  16. Kartau M, Verkkoniemi-Ahola A, Paetau A, Palomäki M, Janes R, Ristola M et al. The Incidence and Predisposing Factors of John Cunningham Virus-Induced Progressive Multifocal Leukoencephalopathy in Southern Finland: A Population-Based Study. Open Forum Infect Dis. 2019; 6: ofz024.

  17. Berger JR, Aksamit AJ, Clifford DB, Davis L, Koralnik IJ, Sejvar JJ et al. PML diagnostic criteria: consensus statement from the AAN Neuroinfectious Disease Section. Neurology. 2013; 80: 1430–1438.

  18. Chalkias S, Gorham JM, Mazaika E, Parfenov M, Dang X, DePalma S et al. ViroFind: A novel target-enrichment deepsequencing platform reveals a complex JC virus population in the brain of PML patients. PloS One 2018; 13: e0186945.

  19. Dang X, Vidal JE, Penalva de Oliveira AC, Simpson DM, Morgello S, Hecht JH et al. JC virus granule cell neuronopathy is associated with VP1 C terminus mutants. J Gen Virol 2012; 93: 175–183.

  20. Toby M, Siddiqui A, Kulasegaram R. Unmasking of progressive multifocal leukoencephalopathy in a patient with HIV-2. Int J STD AIDS 2012; 23: 827–829.

  21. Scholten P, Kralt P, Jacobs B. Posterior fossa progressive multifocal leukoencephalopathy: first presentation of an unknown autoimmune disease. BMJ Case Rep 2017; 2017: bcr-2017-220990.

  22. Whiteman ML, Post MJ, Berger JR, Tate LG, Bell MD, Limonte LP. Progressive multifocal leukoencephalopathy in 47 HIVseropositive patients: neuroimaging with clinical and pathologic correlation. Radiology 1993; 187: 233–240.

  23. Yousry TA, Pelletier D, Cadavid D, Gass A, Richert ND, Radue E-W et al. Magnetic resonance imaging pattern in natalizumabassociated progressive multifocal leukoencephalopathy. Ann Neurol 2012; 72: 779–787.

  24. Tan IL, McArthur JC, Clifford DB, Major EO, Nath A. Immune reconstitution inflammatory syndrome in natalizumab-associated PML. Neurology 2011; 77: 1061–1067.

  25. Marzocchetti A, Di Giambenedetto S, Cingolani A, Ammassari A, Cauda R, De Luca A. Reduced rate of diagnostic positive detection of JC virus DNA in cerebrospinal fluid in cases of suspected progressive multifocal leukoencephalopathy in the era of potent antiretroviral therapy. J Clin Microbiol 2005; 43: 4175–4177.

  26. Pavlovic D, Patera AC, Nyberg F, Gerber M, Liu M, Progressive Multifocal Leukeoncephalopathy Consortium. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord 2015; 8: 255–273.

  27. Cortese I, Muranski P, Enose-Akahata Y, Ha S-K, Smith B, Monaco M et al. Pembrolizumab Treatment for Progressive Multifocal Leukoencephalopathy. N Engl J Med 2019; 380: 1597–1605.

  28. Falcó V, Olmo M, del Saz SV, Guelar A, Santos JR, Gutiérrez M et al. Influence of HAART on the clinical course of HIV-1-infected patients with progressive multifocal leukoencephalopathy: results of an observational multicenter study. J Acquir Immune Defic Syndr 1999 2008; 49: 26–31.

  29. Frattaroli P, Chueng TA, Abaribe O, Ayoade F. Immune Reconstitution Inflammatory Syndrome with Recurrent Paradoxical Cerebellar HIV-Associated Progressive Multifocal Leukoencephalopathy. Pathog Basel Switz 2021; 10: 813.




2020     |     www.medigraphic.com