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.
- Ara-C, cytosine-arabinoside
- JCV, JC virus
- MRI, magnetic resonance imaging
- PCR, polymerase chain reaction
- PML, progressive multifocal leucoencephalopathy
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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.
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