A report of seven cases of progressive multifocal leukoencephalopathy in patients with acquired immune deficiency syndrome |
Dong Myoung Kwak, Hyunil Jeong, Sang Min Park, Hyuck Hwan Cha, Ja Yong Jung, Ji Hwan Bang, Hyoung Shik Shin |
전남대학교 의과대학 알레르기내과 |
후천성 면역 결핍증 환자에서 발생한 진행성 다발성 백질뇌병증 7예 |
곽동명, 정현일, 박상민, 차혁환, 정자영, 방지환, 신형식 |
Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnnam National University Medical School, Gwangju, Korea |
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Abstract |
Secondary opportunistic central nervous system infections occur in approximately one-third of patients with acquired immune
deficiency syndrome. With the introduction of highly active antiretroviral therapy, the number of opportunistic infection cases has
significantly decreased. However, the number of progressive multifocal leukoencephalopathy (PML) cases caused by opportunistic
human JC polyomavirus has not decreased at a noticeable rate. In this report, seven patients with PML were evaluated at the infectious
disease unit of the National Medical Center.
Six of the 7 patients were not on antiretroviral therapy at the time of diagnosis. The mean patient age of the 6 men and 1 woman
was 39 years. The individual CD4 cell counts were 58, 6, 18, 73, 90, 252, and 94 cells/μL. The mean CD4 cell count was 84 cells/μ
L. The most common clinical manifestation was focal weakness and the temporal lobe was mainly involved. Two of the patients
died 52 days after the diagnosis was made. Three patients survived for more than 1 year without disease progression.
We conclude that one must take a careful patient history, perform a neurological examination, and examine brain magnetic resonance
images in patients with human immunodeficiency virus who show neurological symptoms. (Korean J Med 78:771-775,
2010) |
Key Words:
AIDS; HIV; JC virus; Progressive multifocal leukoencephalopathy |
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