Abstract
End-stage renal disease (ESRD) has a major impact on health and affects more than 600,000 people in the USA. The current mainstay treatments include dialysis and kidney transplantation (KT), and patients who have received KT have a higher quality of life and a lower mortality risk than those on chronic dialysis. Therefore, KT is considered the more preferred treatment modality for patients with ESRD. However, even though KT results in a higher long-term survival rate, the use of immunosuppressants is associated with various complications, including opportunistic infections and malignancies, which may lead to a higher risk of death in the first year after transplantation. Progressive multifocal leukoencephalopathy (PML) is a rare complication following KT, with an incidence of 0.027% in KT recipients. We present a case of PML following immunosuppressant therapy in a patient who received KT.
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References
Astrom KE, Mancall EL, Richardson EP Jr (1958) Progressive multifocal leuko-encephalopathy; a hitherto unrecognized complication of chronic lymphatic leukaemia and Hodgkin’s disease. Brain 81:93–111
Berger JR, Aksamit AJ, Clifford DB, Davis L, Koralnik IJ, Sejvar JJ, Bartt R, Major EO, Nath A (2013) PML diagnostic criteria: consensus statement from the AAN neuroinfectious disease section. Neurology 80:1430–1438
Brew BJ, Davies NW, Cinque P, Clifford DB, Nath A (2010) Progressive multifocal leukoencephalopathy and other forms of JC virus disease. Nat Rev Neurol 6:667–679
Misbah SA (2017) Progressive multi-focal leucoencephalopathy - driven from rarity to clinical mainstream by iatrogenic immunodeficiency. Clin Exp Immunol 188:342–352
Neff RT, Hurst FP, Falta EM, Bohen EM, Lentine KL, Dharnidharka VR, Agodoa LY, Jindal RM, Yuan CM, Abbott KC (2008) Progressive multifocal leukoencephalopathy and use of mycophenolate mofetil after kidney transplantation. Transplantation 86:1474–1478
Ohara H, Kataoka H, Nakamichi K, Saijo M, Ueno S (2014) Favorable outcome after withdrawal of immunosuppressant therapy in progressive multifocal leukoencephalopathy after renal transplantation: case report and literature review. J Neurol Sci 341:144–146
Padgett BL, Walker DL, ZuRhein GM, Eckroade RJ, Dessel BH (1971) Cultivation of papova-like virus from human brain with progressive multifocal leucoencephalopathy. Lancet 1:1257–1260
Pavlovic D, Patera AC, Nyberg F, Gerber M, Liu M (2015) Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord 8:255–273
Shah R, Bag AK, Chapman PR, Cure JK (2010) Imaging manifestations of progressive multifocal leukoencephalopathy. Clin Radiol 65:431–439
Shitrit D, Lev N, Bar-Gil-Shitrit A, Kramer MR (2005) Progressive multifocal leukoencephalopathy in transplant recipients. Transpl Int 17:658–665
Wollebo HS, White MK, Gordon J, Berger JR, Khalili K (2015) Persistence and pathogenesis of the neurotropic polyomavirus JC. Ann Neurol 77:560–570
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Lin, TC., Wu, MY., Luh, HT. et al. Progressive multifocal leukoencephalopathy in a renal transplant patient. J. Neurovirol. 25, 612–615 (2019). https://doi.org/10.1007/s13365-019-00749-8
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DOI: https://doi.org/10.1007/s13365-019-00749-8