Progressive Multifocal Leukoencephalitis In A Patient With Systemic Lupus Erythematosus On Hydroxychloroquine
2012
Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the central nervous system. Reactivation of the polyomavirus JC in immunosuppressed patients induces a lytic infection of oligodendrocytes. The disease is usually fatal in a few months and survivors experience severe neurologic deficits. It is well known to be associated with conditions such as HIV, malignancies, organ transplant recipients and those with chronic inflammatory diseases on immunosuppressive therapy. Review of the medical literature revealed only a few case reports of this disease occurring in minimally immunosuppressed patients (1,3,6). We report a patient with systemic lupus erythematosus on minimal iatrogenic immunosuppression that subsequently developed PML.
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