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Inflammatory progressive multifocal leukoencephalopathy in human immunodeficiency virus-negative patients

Submitted by dcc on Wed, 04/23/2014 - 7:47am
TitleInflammatory progressive multifocal leukoencephalopathy in human immunodeficiency virus-negative patients
Publication TypeJournal Article
Year of Publication2007
AuthorsHuang, D, Cossoy, MB, Li, M, Choi, D, Taege, A, Staugaitis, SM, Rehm, S, Ransohoff, RM
JournalAnnals of Neurology
Volume62
Pagination34-9
Date Published2007
KeywordsAdult, Aged, Antiretroviral Therapy, Biopsy, Brain, CD4 Lymphocyte Count, Chi-Square Distribution, Citation, External, Female, Highly Active, HIV, HIV Infections, Humans, Leukoencephalopathy, Magnetic Resonance Imaging, Male, Middl, Progressive Multifocal
Abstract

OBJECTIVE: Inflammatory progressive multifocal leukoencephalopathy (iPML) with enhancing magnetic resonance imaging (MRI) lesions and leukocyte infiltration occurs in human immunodeficiency virus (HIV)-infected individuals after highly active antiretroviral therapy (HAART) treatment. MRI diagnostic criteria for PML suggest that iPML does not occur in HIV-negative individuals. METHODS: We studied pathologically proved PML (12 by biopsy, 9 with MRI, 32 at autopsy). RESULTS: HIV-negative (2/5) and -positive (2/4) PML patients had enhancing MRI lesions, correlated with CD3(+) lymphocyte infiltration. Inflammatory infiltrates occurred in the majority of HIV-negative (7/8) and HIV-positive/HAART (17/20) cases (p > 0.2), but in only 2 of 16 HIV-positive/non-HAART cases (p < 0.001). INTERPRETATION: iPML showed radiographic and pathological similarity in HIV-positive/HAART and HIV-negative patients. HIV-negative iPML necessitates further consideration of MRI criteria for PML.
URLhttp://www.ncbi.nlm.nih.gov/pubmed/17328067