Progressive multifocal leukoencephalopathy after liver transplantation can have favorable or unfavorable outcome.
Transpl Infect Dis
; 18(4): 606-10, 2016 Aug.
Article
em En
| MEDLINE
| ID: mdl-27224849
ABSTRACT
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the JC polyomavirus (JCPyV) in immunocompromised patients, including solid organ transplant recipients. We report 2 cases of PML late after liver transplantation (144 and 204 months) and review the few other published cases. The clinical course of PML is characterized by a rapid progressive neurological decline coinciding with the presence of white matter lesions on magnetic resonance images. No direct antiviral therapy is available against the JCPyV. The prognosis is therefore extremely poor. Restoration of the immune response achieved by tapering or ending the immunosuppressive therapy is the basis of treatment in transplanted patients. One of our patients is alive 3 years after diagnosis after total withdrawal of immunosuppressive therapy. The other presented severe rejection when tapering immunosuppression and died 26 months after diagnosis.
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Base de dados:
MEDLINE
Assunto principal:
Terapia de Imunossupressão
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Leucoencefalopatia Multifocal Progressiva
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Transplante de Fígado
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Hospedeiro Imunocomprometido
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Vírus JC
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Rejeição de Enxerto
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article