Liem HN, Duque VM, de la Paz BT Torres FA, Cárdenas GA, Veitia VAY

Language: Spanish
References: 12
Page: 1-9
PDF size: 308.32 Kb.

ABSTRACT

Introduction: Progressive multifocal leukoencephalopathy is a demyelinating disease of viral etiology that affects the central nervous system. It presents in patients with immunosuppressive conditions and location in the posterior fossa is rare. Due to its unspecific clinical forms, its diagnosis is infrequent, leading to irreversible damage and/or the patient's death.
Objective: Instruct about the possibility of cerebellar progressive multifocal leukoencephalopathy in immunocompromised patients with neurological manifestations of posterior fossa damage.
Clinical case: A case is presented of a male 25-year-old patient without apparent pathological antecedents who started out with slurred speech, mixed tremor, dysmetria and ataxia. Cerebellar progressive multifocal leukoencephalopathy was diagnosed by clinical picture, neuroimaging and the presence of JC virus in the cerebrospinal fluid, alongside severe immunosuppression caused by human immunodeficiency virus diagnosed by serological testing.

REFERENCES

1. Scholten P, Kralt P, Jacobs B. Posterior fossa progressive multifocal leukoencephalopathy: first presentation of an unknown autoimmune disease. BMJ Case Rep. 2017. Doi: https://doi.org/10.1136/bcr-2017-220990.

2. Sami Saribas A, Pascale C, Bouaziz S, Mahmut S. expression of novel proteins by polyomaviruses and recent advances in the structural and functional features of agnoprotein of JC virus, BK virus, and simian virus 40. Journal Cellular Physiology. 2019. Doi: https://doi.org/10.1002/jcp.27715.

3. Sami Saribas A, Mahmut S. A comprehensive proteomics analysis of JC virus agnoprotein-interacting proteins: agnoprotein primarily targets the host proteins with coiled-coil motifs. Virology. 2020. Doi: https://doi.org/10.1016/j.virol.2019.10.005.

4. Garcia CR, San Jose MB. Cerebellar Involvement in an Immunocompetent Patient Presenting with Progressive Multifocal Leukoencephalopathy. Hindawi Case Reports in Neurological Medicine. 2017. Doi: https://doi.org/10.1155/2017/2396068.

5. Gnocchi M, Salamano R, Mañana G, Lasalvia E, Riera R, Hernández O. Leucoencefalopatía multifocal progresiva: a propósito de un caso clínico-patológico en un paciente infectado por VIH. Rev Med Uruguay. 2003;(19):78-82..

6. Chiao-Feng C, Jen-Jen S, Ya-Fang C, Yen-Chun L, Yi-Min H. Case Report, Progressive multifocal leukoencephalopathy in a 27-year-old lady with systemic lupus erythematosus e rheumatoid arthritis overlap syndrome. Journal of the Formosan Medical Association. 2019. Doi: https://doi.org/10.1016/j.jfma.2019.05.021.

7. Molloy ES, Calabrese CM, Calabrese LH. The risk of progressive multifocal leukoencephalopathy in the biologic era: prevention and management. Rheum Dis Clin N Am. 2017. Doi: https://doi.org/10.1016/j.rdc.2016.09.009.

8. Major EO, Yousry TA, Clifford DB. Pathogenesis of progressive multifocal leukoencephalopathy and risks associated with treatments for multiple sclerosis: a decade of lessons learned. Lancet Neurol. 2018. Doi: https://doi.org/10.1016/S1474-4422(18)30040-1.

9. Sancho Rubio MC, Garijo Gallego C, Villar Yus C. Leucoencefalopatía multifocal progresiva en paciente con diagnóstico tardío de SIDA, reporte de caso. Rev Clin Med Fam. 2018;11(3):176-8..

10. Hamaguchi M, Suzuki K, Fujita H. Successful treatment of non-HIV progressive multifocal leukoencephalopathy: case report and literature review. J Neurol. 2019. Doi: https://doi.org/10.1007/s00415-019-09629.

11. Aotsuka Y, Uzawa A, Nishimura K, Kojima K, Yamaguchi M, Makino T, et al. Progressive multifocal leukoencephalopathy localized in the cerebellum and brainstem associated with idiopathic CD4 (+) T lymphocytopenia. Intern Med. 2016. Doi: https://doi.org/10.2169/internalmedicine.55.6649.

12. Berger JR, Aksamit AJ, Clifford DB. PML diagnostic criteria: consensus statement from the AAN Neuroinfectious disease section. Neurology. 2013. Doi: https://doi.org/10.1212/WNL.0b013e31828c2fa1.