Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report
<p>Abstract</p> <p>Introduction</p> <p>Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham...
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| Format: | Article |
| Language: | English |
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BMC
2012-07-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://www.jmedicalcasereports.com/content/6/1/177 |
| _version_ | 1828418628552228864 |
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| author | Troppmann Martina Büttner Roland Böwer Michael Salzberger Bernd |
| author_facet | Troppmann Martina Büttner Roland Böwer Michael Salzberger Bernd |
| author_sort | Troppmann Martina |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham virus in a case of an early stage plasmacytoma.</p> <p>Case presentation</p> <p>A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance imaging demonstrated new hyperattenuating lesions in the right thalamus and left-sided subcortically. A polymerase chain reaction test revealed 4500 copies of John Cunningham virus-deoxyribonucleic acid/ml in cerebrospinal fluid. Human immunodeficiency virus infection was ruled out. A bone marrow biopsy showed an early stage immunoglobulin G-kappa plasmacytoma. Cidofovir (5mg/kg) weekly for three weeks was started. A significant improvement of her neuropsychological symptoms was achieved, but motor system and sensory symptoms did not change.</p> <p>Conclusions</p> <p>This case shows a rapid course of progressive multifocal leukoencephalopathy with severe residual deficits. In the diagnostic workup of all patients with atypical neurologic symptoms or immunodeficiency, progressive multifocal leukoencephalopathy should be included as a differential diagnosis.</p> |
| first_indexed | 2024-12-10T14:39:58Z |
| format | Article |
| id | doaj.art-3fbb9648ae0e438996f6537063e17570 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-10T14:39:58Z |
| publishDate | 2012-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3fbb9648ae0e438996f6537063e175702022-12-22T01:44:42ZengBMCJournal of Medical Case Reports1752-19472012-07-016117710.1186/1752-1947-6-177Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case reportTroppmann MartinaBüttner RolandBöwer MichaelSalzberger Bernd<p>Abstract</p> <p>Introduction</p> <p>Progressive multifocal leukoencephalopathy is an opportunistic infection occurring in patients with severe cellular immunodeficiency. This case highlights the role of cellular immunodeficiency in the reactivation of John Cunningham virus in a case of an early stage plasmacytoma.</p> <p>Case presentation</p> <p>A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance imaging demonstrated new hyperattenuating lesions in the right thalamus and left-sided subcortically. A polymerase chain reaction test revealed 4500 copies of John Cunningham virus-deoxyribonucleic acid/ml in cerebrospinal fluid. Human immunodeficiency virus infection was ruled out. A bone marrow biopsy showed an early stage immunoglobulin G-kappa plasmacytoma. Cidofovir (5mg/kg) weekly for three weeks was started. A significant improvement of her neuropsychological symptoms was achieved, but motor system and sensory symptoms did not change.</p> <p>Conclusions</p> <p>This case shows a rapid course of progressive multifocal leukoencephalopathy with severe residual deficits. In the diagnostic workup of all patients with atypical neurologic symptoms or immunodeficiency, progressive multifocal leukoencephalopathy should be included as a differential diagnosis.</p>http://www.jmedicalcasereports.com/content/6/1/177Progressive multifocal leukoencephalopathy (PML)Polyomavirus JC (JCV)CidofovirPlasmacytoma |
| spellingShingle | Troppmann Martina Büttner Roland Böwer Michael Salzberger Bernd Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report Journal of Medical Case Reports Progressive multifocal leukoencephalopathy (PML) Polyomavirus JC (JCV) Cidofovir Plasmacytoma |
| title | Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report |
| title_full | Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report |
| title_fullStr | Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report |
| title_full_unstemmed | Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report |
| title_short | Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report |
| title_sort | smoldering myeloma presenting as progressive multifocal leukoencephalopathy a case report |
| topic | Progressive multifocal leukoencephalopathy (PML) Polyomavirus JC (JCV) Cidofovir Plasmacytoma |
| url | http://www.jmedicalcasereports.com/content/6/1/177 |
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