ABSTRACT
INTRODUCTION: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of central nervous system due to the JC virus. PML generally occurs in immunocompromised hosts and has a fatal outcome. OBSERVATION: We report a case of an atypical PML in a patient with pulmonary sarcoidosis: MRI showed multifocal and punctate contrast enhancements. The diagnostic was made by brain biopsy. CONCLUSION: The pathophysiology of this association is probably related to the immunodepression induced by sarcoidosis.
Subject(s)
Leukoencephalopathy, Progressive Multifocal/etiology , Sarcoidosis, Pulmonary/complications , Adult , Brain/pathology , Demyelinating Diseases/pathology , Humans , Immunohistochemistry , Leukoencephalopathy, Progressive Multifocal/diagnosis , Leukoencephalopathy, Progressive Multifocal/pathology , Magnetic Resonance Imaging , Male , Sarcoidosis, Pulmonary/diagnosis , Sarcoidosis, Pulmonary/pathologyABSTRACT
We report a case of thrombotic thrombocytopenic purpura (TTP) in a 47-year-old woman, who presented fluctuating visual disturbances which had developed over the last six months. An antiphospholipid syndrome was suspected and intravenous heparin treatment was started. One week later, hemolytic anemia and renal insufficiency occurred. Severe deficiency of von Willebrand factor-cleaving protease was found and a diagnostic of TTP was made. The clinical outcome was favorable after treatment with plasmapheresis and fresh frozen plasma. Diagnosis, etiology and treatment of this life-threatening disease are discussed.
Subject(s)
Purpura, Thrombotic Thrombocytopenic/complications , Vision Disorders/etiology , Brain/pathology , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Plasmapheresis/methods , Purpura, Thrombotic Thrombocytopenic/pathology , Purpura, Thrombotic Thrombocytopenic/therapy , Treatment Outcome , Vision Disorders/pathology , Vision Disorders/therapy , von Willebrand Factor/geneticsABSTRACT
Current treatment of glioblastomas relies on surgical resection, radiotherapy and chemotherapy. However, the efficacy of these therapeutics is still limited and new therapeutic approaches based on the understanding of brain tumor biology are emerging. High expression of the EGF receptor by tumor cells, activation of the PI3K/Akt and the Ras/Raf pathways represent interesting targets for new selective drugs under development. The most promising drugs are currently antiangiogenic agents. This article reviews these emerging therapies currently under clinical trials in glioblastomas.
