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

Abstract

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.

• Authors: Yuya Aotsuka, Akiyuki Uzawa, Kazutaka Nishimura, Kazuho Kojima, Mika Yamaguchi, Takahiro Makino, Kazuo Nakamichi, Masayuki Saijo, Satoshi Kuwabara
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 55 Issue 12 Pg. 1645-7 ( 2016) ISSN: 1349-7235 [Electronic] Japan
• PMID: 27301521 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Aged
• Brain Stem (diagnostic imaging, pathology)
• Cerebellum (diagnostic imaging, pathology)
• Female
• Humans
• Japan
• Leukoencephalopathy, Progressive Multifocal (diagnostic imaging, etiology, pathology)
• Lymphopenia (complications)
• Magnetic Resonance Imaging
• Male
• Middle Aged