Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S60-S64, 2007

Progressive Multifocal Leukoencephalopathy in an Immunocompetent Taiwanese Patient

  • Yung-Yee Chang

      Affiliations

    • Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Min-Yu Lan

      Affiliations

    • Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Cheng-Huei Peng

      Affiliations

    • Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • Hsiu-Shan Wu

      Affiliations

    • Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
    • ,
  • DeChing Chang

      Affiliations

    • Institute of Molecular Biology, National Chung-Cheng University, Chia-Yi, Taiwan
    • ,
  • Jia-Shou Liu

      Affiliations

    • Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Jia-Shou Liu, Department of Neurology, Kaohsiung Chang-Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung, Kaohsiung 833, Taiwan

Received 31 August 2005; received in revised form 2 November 2005; accepted 10 January 2006.

Article Outline

Progressive multifocal leukoencephalopathy (PML) is a deadly demyelinating brain disease caused by JC virus (JCV). Genomic analysis of viral isolates in these cases often shows prototype-like JCV and its variants, which is a virulent strain compared to the latent archetype virions mostly found in the kidney. Here, we report a 57-year-old man who suffered from a subacute course of cognitive impairment and multiple neurologic deficits. Neuroimaging, pathology, and virology studies showed multifocal leukoencephalopathy and the presence of JCV deoxyribonucleic acid in the cerebrospinal fluid. The prototype type 1 (Mad-1) strain of JCV was identified on viral genotyping obtained from brain tissue. No immune deficits were found. He responded poorly to a-interferon and antiviral treatment. This case suggests that lack of immune deficiency cannot exclude the possibility of PML as a cause of subacute leukoencephalopathy. Accumulated data with respect to the disease course, pathologic feature, and viral genomic subtyping may pave the way for future treatment against this devastating disease. [J Formos Med Assoc 2007;106(2 Suppl):S60-S64]

Key Words:  genotyping , JC virus , magnetic resonance imaging , polymerase chain reaction , progressive multifocal leukoencephalopathy

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PII: S0929-6646(09)60355-7

doi:10.1016/S0929-6646(09)60355-7

Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S60-S64, 2007

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