Jancar Nina, Sousa Gonçalves Filipa, Duro José, Lessa Simões Mariana, Aguiar Patrício
Internal Medicine, Hospital de Santa Maria, North Lisbon University Hospital Center (CHULN), Lisbon, PRT.
Cureus. 2022 Dec 25;14(12):e32912. doi: 10.7759/cureus.32912. eCollection 2022 Dec.
Progressive multifocal leukoencephalopathy is a rare, progressive demyelinating disease of the central nervous system caused by reactivation and replication of the John Cunningham (JC) virus in cerebral oligodendrocytes. The JC virus is a small ubiquitous polyomavirus that can be detected in up to 50% of the adult population. It affects almost exclusively immunocompromised patients and is generally observed in patients with acquired immunodeficiency syndrome and patients with hematologic malignancies and autoimmune or chronic inflammatory diseases medicated with immunosuppressive and immunomodulatory drugs. However, it is rarely described in patients with hematologic malignancies, not undergoing chemotherapy or immunosuppressive therapy. It has a poor prognosis, and the treatment is based on restoring the immune system, given that no specific antiviral treatment is available. We present a case of a chemotherapy-naive patient with chronic lymphocytic leukemia associated with progressive multifocal leukoencephalopathy.
进行性多灶性白质脑病是一种罕见的中枢神经系统进行性脱髓鞘疾病，由约翰·坎宁安（JC）病毒在脑少突胶质细胞中重新激活和复制引起。JC病毒是一种普遍存在的小型多瘤病毒，在高达50%的成年人群中可检测到。它几乎只影响免疫功能低下的患者，通常见于获得性免疫缺陷综合征患者、血液系统恶性肿瘤患者以及接受免疫抑制和免疫调节药物治疗的自身免疫性或慢性炎症性疾病患者。然而，在未接受化疗或免疫抑制治疗的血液系统恶性肿瘤患者中很少有相关描述。其预后较差，由于没有特效抗病毒治疗方法，治疗主要基于恢复免疫系统。我们报告一例未接受过化疗的慢性淋巴细胞白血病患者合并进行性多灶性白质脑病的病例。
