論文種別	症例報告
言語種別	英語
査読の有無	その他(不明)
表題	Inflammatory progressive multifocal leukoencephalopathy with human T-cell lymphotropic virus-1 coinfection.
掲載誌名	正式名：BMJ case reports 略　 称：BMJ Case Rep ISSNコード：1757790X/1757790X
巻・号・頁	17(4),pp.e257805
著者・共著者	Sachiko Hasebe, Kota Maekawa, Yukiko Shishido-Hara, Kazuo Nakamichi, Nobuaki Funata, Makio Takahashi
発行年月	2024/04
概要	A middle-aged man with progressive multifocal leukoencephalopathy (PML) in a human T-cell lymphotropic virus type-1 (HTLV-1) carrier on haemodialysis presented with mild dysarthria and ataxia. Brain MRI revealed asymmetric T2-hyperintense lesions in the cerebral white matter, cerebellum and brainstem. A small amount of JC virus (JCV) genome in cerebrospinal fluid was detected by PCR and cerebellar biopsy demonstrated JCV-DNA presence. Pathological findings showed demyelinating lesions and glial cells with mildly enlarged nuclei, accompanied by T-lymphocytes, neutrophils and plasma cell infiltration. The CD4+/CD8+ratio was 0.83. High-dose corticosteroid therapy was effective for inflammatory PML lesions, and the administration of mefloquine combined with mirtazapine led to favourable outcome. The encephalitis in this case is considered to have occurred secondarily to JCV infection in the presence of HTLV-1 infection. Therefore, it is crucial to investigate the presence of HTLV-1 in order to understand the aetiology of this brain inflammation.
DOI	10.1136/bcr-2023-257805
PMID	38688573