Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
CASE REPORTS
Brain Biopsy Is More Reliable than the DNA test for JC Virus in Cerebrospinal Fluid for the Diagnosis of Progressive Multifocal Leukoencephalopathy
Junji IkedaAkira MatsushimaWataru IshiiTetuya GotoKenta TakahashiKazuo NakamichiMasayuki SaijoYoshiki SekijimaShu-ichi Ikeda
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JOURNALS OPEN ACCESS

2017 Volume 56 Issue 10 Pages 1231-1234

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Abstract

The current standard diagnostic approach for progressive multifocal leukoencephalopathy (PML) is to perform a DNA test to identify the presence of the JC virus in cerebrospinal fluid (CSF). A 32-year-old woman with a 5-year history of systemic lupus erythematosus developed right hemiplegia and motor aphasia. MRI revealed a large white matter lesion in the left frontal lobe. JC virus DNA was undetectable in the CSF, but a brain biopsy showed typical histopathology and a high DNA load of the JC virus. The patient was treated with mefloquine and mirtazapine, and is currently alive at 24 months after onset. An early brain biopsy may therefore be important for making a timely diagnosis of PML.

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© 2017 by The Japanese Society of Internal Medicine
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