Bernal-Cano F, Joseph J T, Koralnik I J
Department of Neurology, Division of Viral Pathogenesis, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
J Neurovirol. 2007 Oct;13(5):474-6. doi: 10.1080/13550280701469178.
Progressive multifocal leukoencephalopathy (PML) is a deadly demyelinating disease of the central nervous system, which occurs in immunosuppressed individuals. This disease is caused by a reactivation of the polyomavirus JC (JCV). Clinical presentation can be variable from patient to patient as lesions can occur anywhere in the CNS white matter; however, they appear to spare the optic nerves and the spinal cord. The authors present a case of PML in the setting of acquired immunodeficiency syndrome (AIDS) who developed PML lesions in the spinal cord, discovered during the postmortem examination. This finding is significant because PML has recently been diagnosed in patients with multiple sclerosis (MS) treated with the novel immunomodulatory medication natalizumab. Indeed, spinal cord lesions are frequent in MS. Therefore clinicians should be aware that in addition to the brain, PML may also affect the spinal cord white matter.
进行性多灶性白质脑病（PML）是一种发生于免疫功能低下个体的致命性中枢神经系统脱髓鞘疾病。该疾病由多瘤病毒JC（JCV）的重新激活引起。由于病变可发生于中枢神经系统白质的任何部位，不同患者的临床表现可能有所不同；然而，视神经和脊髓似乎不受影响。作者报告了一例获得性免疫缺陷综合征（AIDS）患者发生PML的病例，该患者在尸检时发现脊髓出现PML病变。这一发现具有重要意义，因为近期在接受新型免疫调节药物那他珠单抗治疗的多发性硬化症（MS）患者中也诊断出了PML。事实上，脊髓病变在MS中很常见。因此，临床医生应意识到，除了大脑，PML也可能影响脊髓白质。
