Division for Infectious Diseases, Department for Clinical and Experimental Medicine, Faculty of Health Sciences, 581 85 Linköping, Sweden.
J Clin Virol. 2010 Aug;48(4):291-3. doi: 10.1016/j.jcv.2010.05.003. Epub 2010 Jun 16.
We report a case of progressive multifocal leukoencephalopathy (PML) in a woman with non-Hodgkin lymphoma treated with chemotherapy in combination with rituximab. She presented with rapid deterioration of vision and subsequently cognitive decline. Magnetic resonance imaging (MRI) of the brain raised the suspicion of PML. The first PCR analysis of the cerebrospinal fluid (CSF) was negative, but a second sample was positive for JC virus DNA. Anti-viral treatment was ineffective and the patient died 7 months after debut of symptoms. Our case emphasizes the importance of the awareness of PML in patients with progressive neurological symptoms treated with antilymphocytic drugs and that consecutive CSF analyses may be needed to detect the JC virus.
我们报告了一例非霍奇金淋巴瘤患者在接受化疗联合利妥昔单抗治疗后发生进行性多灶性白质脑病（PML）。她表现为视力迅速恶化，随后认知能力下降。脑部磁共振成像（MRI）提示 PML 可能性大。首次对脑脊液（CSF）的 PCR 分析结果为阴性，但第二次样本的 JC 病毒 DNA 为阳性。抗病毒治疗无效，患者在出现症状后 7 个月死亡。我们的病例强调了在接受淋巴细胞药物治疗的进展性神经症状患者中对 PML 的认识的重要性，并且可能需要连续进行 CSF 分析以检测 JC 病毒。
