Article Text

PDF
Favourable outcome of progressive multifocal leucoencephalopathy in two patients with dermatomyositis
  1. S Vulliemoz1,
  2. F Lurati-Ruiz2,
  3. F-X Borruat3,
  4. J Delavelle4,
  5. I J Koralnik5,
  6. T Kuntzer6,
  7. J Bogousslavsky6,
  8. F Picard1,
  9. T Landis1,
  10. R A Du Pasquier6
  1. 1Service de Neurologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
  2. 2Service d’ Immunologie et allergologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
  3. 3Unité de Neuro-ophtalmologie, Centre Hospitalier Universitaire Vaudois, Lausanne
  4. 4Unité de Neuro-radiologie, Hôpitaux Universitaires de Genève
  5. 5HIV/Neurology Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  6. 6Service de Neurologie, Centre Hospitalier Universitaire Vaudois
  1. Correspondence to:
 R A Du Pasquier
 Service de Neurologie and Service d’Immunologie, Centre Hospitalier Universitaire Vaudois, BT-02 1011 Lausanne, Switzerland; renaud.Du-Pasquier{at}chuv.ch

Abstract

Progressive multifocal leucoencephalopathy (PML), a demyelinating disease caused by the JC virus (JCV), occurs in immunosuppressed patients and carries a poor prognosis. A favourable outcome is reported in two patients with PML and dermatomyositis. Immunosuppressive drugs were stopped in patient 1 but could only be partially tapered in patient 2. The JCV-specific CD8+ T cell response was strong in patient 1 and weak in patient 2. Both were treated with cytosine-arabinoside, and patient 2 was also treated with mirtazapine, a 5HT2A receptor antagonist. Combination of these drugs might be helpful to treat HIV-negative patients with PML.

Statistics from Altmetric.com

Footnotes

  • This work was supported in part by grants from the Swiss National Foundation (FN 3200BO-104262 and PP00B-106716) and from the Swiss Society for Multiple Sclerosis to RADP, and grants R01 NS/AI 041198 and 047029 from the National Institutes of Health, USA to IJK.

  • Competing interests: None declared.

  • Informed consent was obtained from the patients described in this report.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.