Crowder Clinton D, Gyure Kymberly A, Drachenberg Cinthia B, Werner Joseph, Morales Robert E, Hirsch Hans H, Ramos Emilio
Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Am J Transplant. 2005 May;5(5):1151-8. doi: 10.1111/j.1600-6143.2005.00800.x.
We report the case of a 47-year-old man who developed progressive multifocal leukoencephalopathy (PML) after receiving immuno-suppressive therapy for renal transplantation. The patient presented with a focal seizure and cognitive changes 5 months post-transplantation. He was found to have enhancing lesions in the parietal lobe and typical findings of PML in a brain biopsy. Immunosuppression was discontinued and the neurological symptoms gradually resolved over a period of 4 weeks. The patient is free of any neurological symptoms 36 months after the diagnosis of PML and imaging studies demonstrate resolution of the PML lesions. The patient returned to hemodialysis 3 months after immunosuppression was discontinued. We also present a review of the literature on PML in renal transplant recipients.
我们报告了一例47岁男性患者,该患者在接受肾移植免疫抑制治疗后发生了进行性多灶性白质脑病(PML)。患者在移植后5个月出现局灶性癫痫发作和认知改变。脑部活检发现其顶叶有强化病变及PML的典型表现。免疫抑制治疗中断,神经症状在4周内逐渐缓解。在诊断PML 36个月后,患者无任何神经症状,影像学检查显示PML病变已消退。免疫抑制治疗中断3个月后,患者恢复了血液透析。我们还对肾移植受者中PML的文献进行了综述。