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氯丙嗪联合西多福韦治疗1例进行性多灶性白质脑病患者。

Chlorpromazine combined with cidofovir for treatment of a patient suffering from progressive multifocal leukoencephalopathy.

作者信息

Pöhlmann Christoph, Hochauf Kristina, Röllig Christoph, Schetelig Johannes, Wunderlich Olaf, Bandt Dirk, Ehninger Gerhard, Jacobs Enno, Rohayem Jacques

机构信息

Institut für medizinische Mikrobiologie und Hygiene, Dresden, Deutschland.

出版信息

Intervirology. 2007;50(6):412-7. doi: 10.1159/000112916. Epub 2008 Jan 8.

Abstract

We report on a stem cell-transplanted patient with B cell chronic lymphatic leukemia who presented with a subacute onset of focal neurological deficits, gait abnormalities, emotional lability and dementia. Progressive multifocal leukoencephalopathy was diagnosed by magnetic resonance imaging (MRI) of the brain and detection of JC virus genome in the cerebrospinal fluid. Cidofovir and the 5HT2A receptor antagonist chlorpromazine were subsequently administered. A follow-up MRI of the brain 2 weeks after initiation of the antiviral therapy displayed progress of the demyelination, and the patient died 3 months after onset of the neurological symptoms. This report highlights the need for the development of novel and potent strategies for treatment of progressive multifocal leukoencephalopathy.

摘要

我们报告了一名接受干细胞移植的B细胞慢性淋巴细胞白血病患者,该患者出现局灶性神经功能缺损、步态异常、情绪不稳定和痴呆的亚急性发作。通过脑部磁共振成像(MRI)和脑脊液中JC病毒基因组的检测诊断为进行性多灶性白质脑病。随后给予西多福韦和5-羟色胺2A受体拮抗剂氯丙嗪。抗病毒治疗开始2周后的脑部随访MRI显示脱髓鞘进展,患者在神经症状出现3个月后死亡。本报告强调了开发治疗进行性多灶性白质脑病的新型有效策略的必要性。

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