Reznik M, Halleux J, Urbain E, Mouchette R, Castermans P, Beaujean M
Acta Neuropathol Suppl. 1981;7:189-91. doi: 10.1007/978-3-642-81553-9_57.
Progressive multifocal leukoencephalopathy (PML) occurred in two patients after kidney transplantation. Less than 2 years after such a transplantation associated with immunosuppressive chemotherapy a 54-year-old male developed polyneuropathy then clinical diffuse alteration of the central nervous system. He died three months later with the suspicion of hypertensive encephalopathy due to progressive renal failure. A 45-year-old female had a kidney transplantation first rapidly complicated by Listeria monocytogenes meningoencephalitis. She was cured from this disease and had a satisfactory social rehabilitation during two years. Afterwards, she suffered various neurological troubles, including epilepsy, that were attributed to combined renal failure and developing hydrocephalus. One year after the onset of these neurological symptoms, the grafted kidney was removed and chemotherapy was discontinued. She died three months later. Both patients had typical PML with eosinophilic intranuclear inclusions in presumptive oligodendroglial cells. By electron microscopy, performed on formalin fixed brain tissue, round particles (40-50 nm) could be recognized in some glial cell nuclei. These two cases are confronted with the four published observations of PML following organ transplantation.
两名肾移植患者发生了进行性多灶性白质脑病（PML）。在这种与免疫抑制化疗相关的移植后不到2年，一名54岁男性出现了多发性神经病，随后出现中枢神经系统的临床弥漫性改变。三个月后，他因进行性肾衰竭疑似高血压脑病而死亡。一名45岁女性首次进行肾移植后迅速并发单核细胞增生李斯特菌脑膜脑炎。她从这种疾病中康复，在两年内社会康复情况良好。之后，她出现了各种神经问题，包括癫痫，这些问题被归因于合并肾衰竭和脑积水的发展。这些神经症状出现一年后，切除了移植的肾脏并停止了化疗。三个月后她去世。两名患者均患有典型的PML，在假定的少突胶质细胞中有嗜酸性核内包涵体。通过对福尔马林固定的脑组织进行电子显微镜检查，在一些神经胶质细胞核中可以识别出圆形颗粒（40 - 50纳米）。这两例病例与已发表的4例器官移植后发生PML的观察结果相对照。
