• Internal medicine · Jan 2017

    Case Reports

    Brain Biopsy Is More Reliable than the DNA test for JC Virus in Cerebrospinal Fluid for the Diagnosis of Progressive Multifocal Leukoencephalopathy.

    • Junji Ikeda, Akira Matsushima, Wataru Ishii, Tetuya Goto, Kenta Takahashi, Kazuo Nakamichi, Masayuki Saijo, Yoshiki Sekijima, and IkedaShu-IchiSIDepartment of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan..
    • Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
    • Intern. Med. 2017 Jan 1; 56 (10): 123112341231-1234.

    AbstractThe current standard diagnostic approach for progressive multifocal leukoencephalopathy (PML) is to perform a DNA test to identify the presence of the JC virus in cerebrospinal fluid (CSF). A 32-year-old woman with a 5-year history of systemic lupus erythematosus developed right hemiplegia and motor aphasia. MRI revealed a large white matter lesion in the left frontal lobe. JC virus DNA was undetectable in the CSF, but a brain biopsy showed typical histopathology and a high DNA load of the JC virus. The patient was treated with mefloquine and mirtazapine, and is currently alive at 24 months after onset. An early brain biopsy may therefore be important for making a timely diagnosis of PML.

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