特发性 CD4 淋巴细胞减少症继发进行性多灶性白质脑病，用帕博利珠单抗治疗。
Progressive multifocal leukoencephalopathy secondary to idiopathic CD4 lymphocytopenia treated with pembrolizumab.
机构信息
King's College Hospital NHS Foundation Trust, London, United Kingdom.
Maidstone and Tunbridge Wells NHS Tust, Hermitage Lane Maidstone, Kent, United Kingdom.
出版信息
J Neuroimmunol. 2023 Dec 15;385:578248. doi: 10.1016/j.jneuroim.2023.578248. Epub 2023 Nov 18.
BACKGROUND
Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease due to a lytic infection of oligodendrocytes caused by John Cunningham polyoma virus (JCV) infection. Idiopathic CD4+ T-cell lymphocytopenia (ICL) is a very rare cause of PML.
METHODS
We present an individual with PML secondary to ICL treated with 3 doses of pembrolizumab, a Programmed-Death-1 Immune Checkpoint Inhibitor following with complete resolution of symptoms and conduct a review of the literature.
CONCLUSION
This report illustrates the objective clinical and radiological improvement in a patient with PML due to ICL and suggests further study of immune checkpoint inhibitors as potential treatment for patients with PML.
背景
进行性多灶性白质脑病（PML）是一种罕见的脱髓鞘疾病，由约翰·坎宁安多瘤病毒（JCV）感染导致少突胶质细胞裂解性感染引起。特发性 CD4+T 细胞淋巴细胞减少症（ICL）是 PML 的一个非常罕见的病因。
方法
我们报告了一例由 ICL 继发的 PML 患者，在接受了 3 剂派姆单抗（一种程序性死亡受体-1 免疫检查点抑制剂）治疗后，症状完全缓解，并对文献进行了回顾。
结论
本报告说明了一例由 ICL 引起的 PML 患者的客观临床和影像学改善，并提示进一步研究免疫检查点抑制剂作为 PML 患者潜在治疗方法的可能性。
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