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Neurological Sciences

, Volume 38, Issue 8, pp 1517–1519 | Cite as

Clinical and MRI improvement in a case of progressive multifocal leukoencephalopathy

  • Letizia Tirelli
  • Francesca Rosini
  • Alessandra Rufa
  • Guido Garosi
  • Alfonso Cerase
  • Antonio Federico
  • Andrea De Luca
Letter to the Editor

Dear editor,

Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating CNS disease due to lytic infection of oligodendrocytes by the John Cunningham polyomavirus (JCV), an opportunistic agent requiring immunosuppression to become active, commonly complicating HIV infections, lymphoproliferative disorders or immunosuppressive therapies [1]. PML has been reported in immune-mediated rheumatologic disorders, such as systemic lupus erythematosus (SLE). Currently, no therapies have been approved [2], but many broad-spectrum nucleoside-analogue chemotherapeutics have been tested to inhibit JCV replication. Among these, cidofovir, an acyclic nucleotide-phosphonate analogue of deoxycytosine-monophosphate, has been employed with various outcomes, alone or in combination with mirtazapine, an agonist of serotonin-receptor-2A (5HT2AR) blocking the JCV entry into glial cells. Although the restoration of host adaptive-immune response is the first purpose of PML therapy, a...

Keywords

Systemic Lupus Erythematosus Systemic Lupus Erythematosus Patient Progressive Multifocal Leukoencephalopathy Mirtazapine Natalizumab 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

Authors gratefully thank Doctor Daniele Giuseppe Romano for his help in the brain MRI evaluation.

Compliance with ethical standards

Conflict of interest

None. All authors have approved the final article. Patient’s anonymity was protected in this case report.

References

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Copyright information

© Springer-Verlag Italia 2017

Authors and Affiliations

  • Letizia Tirelli
    • 1
  • Francesca Rosini
    • 2
  • Alessandra Rufa
    • 2
  • Guido Garosi
    • 3
  • Alfonso Cerase
    • 4
  • Antonio Federico
    • 1
  • Andrea De Luca
    • 5
  1. 1.Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic DiseasesUniversity of SienaSienaItaly
  2. 2.Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic DiseasesUniversity of SienaSienaItaly
  3. 3.Nephrology and Dialysis Unit, Department of Internal and Specialty MedicineAzienda Ospedaliera Universitaria SeneseSienaItaly
  4. 4.Unit NINT Neuroimaging and Neurointervention, Department of Neurological and Sensorineural SciencesAzienda Ospedaliera Universitaria SeneseSienaItaly
  5. 5.Department of Internal and Specialty Medicine, University Division of Infectious DiseasesUniversity of SienaSienaItaly

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