Progressive Multifocal Leukoencephalopathy Localized in the Cerebellum and Brainstem Associated with Idiopathic CD4+ T Lymphocytopenia

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease that favors the cerebrum and typically occurs in immunosuppressed patients. We herein report the case of a 66-year-old man with PML, idiopathic CD4+ T lymphocytopenia (ICL), and chronic renal failure. Cranial magnetic resona...

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Bibliographic Details
Published in:Internal Medicine 2016/06/15, Vol.55(12), pp.1645-1647
Main Authors: Aotsuka, Yuya, Uzawa, Akiyuki, Nishimura, Kazutaka, Kojima, Kazuho, Yamaguchi, Mika, Makino, Takahiro, Nakamichi, Kazuo, Saijo, Masayuki, Kuwabara, Satoshi
Format: Article
Language:English
Subjects:
Adult
Aged
Brain Stem - diagnostic imaging
Brain Stem - pathology
brainstem
cerebellum
Cerebellum - diagnostic imaging
Cerebellum - pathology
crescent-shaped
Female
Humans
idiopathic CD4+ T lymphocytopenia
Japan
Leukoencephalopathy, Progressive Multifocal - diagnostic imaging
Leukoencephalopathy, Progressive Multifocal - etiology
Leukoencephalopathy, Progressive Multifocal - pathology
Lymphopenia - complications
Magnetic Resonance Imaging
Male
Middle Aged
progressive multifocal leukoencephalopathy
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Summary:Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease that favors the cerebrum and typically occurs in immunosuppressed patients. We herein report the case of a 66-year-old man with PML, idiopathic CD4+ T lymphocytopenia (ICL), and chronic renal failure. Cranial magnetic resonance imaging (MRI) showed a crescent-shaped lesion in the left cerebellum, brainstem, and middle cerebellar peduncle. Although the patient did not present with HIV infection, collagen diseases, or tumors, JC virus DNA was detected in the cerebrospinal fluid. Clinicians should consider PML and ICL in the differential diagnosis if the patient develops progressive ataxia and a crescent-shaped cerebellar lesion on MRI.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.6649