Progressive multifocal leukoencephalopathy in a patient with lymphoma and presumptive hyper IgE syndrome

J Neurovirol. 2017 Aug;23(4):632-636. doi: 10.1007/s13365-017-0536-x. Epub 2017 Jun 22.

Abstract

We, herein, report a 23-year-old male with a rare inherited immunodeficiency disease, hyperimmunoglobulin IgE syndrome (HIES), who developed progressive multifocal leukoencephalopathy (PML) and lymphoma simultaneously. Primary immunodeficiency of the patient has remained undiagnosed until adulthood. PML is a severe demyelinating disease of the central nervous system caused by John Cunningham virus. HIES is a rare, inherited immunodeficiency characterized by high serum levels of IgE, recurrent staphylococcal infection, eczema, and hypereosinophilia. PML may accompany primary immunodeficiency syndromes, but the association with HIES is exceedingly rare. We discuss the imaging findings, medical management, and a review of related literature on primary immunodeficiency cases complicating with PML.

Keywords: B cell lymphoma; Hyperimmunoglobulin E syndrome (HIES); JC virus; Progressive multifocal leukoencephalopathy (PML).

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Eczema / diagnosis*
  • Eczema / drug therapy
  • Eczema / immunology
  • Eczema / pathology
  • Fatal Outcome
  • Humans
  • Hypereosinophilic Syndrome / diagnosis*
  • Hypereosinophilic Syndrome / drug therapy
  • Hypereosinophilic Syndrome / immunology
  • Hypereosinophilic Syndrome / pathology
  • Immunoglobulin E / blood
  • JC Virus / isolation & purification
  • JC Virus / pathogenicity
  • Job Syndrome / diagnosis*
  • Job Syndrome / drug therapy
  • Job Syndrome / immunology
  • Job Syndrome / pathology
  • Leukoencephalopathy, Progressive Multifocal / diagnosis*
  • Leukoencephalopathy, Progressive Multifocal / drug therapy
  • Leukoencephalopathy, Progressive Multifocal / immunology
  • Leukoencephalopathy, Progressive Multifocal / pathology
  • Lymphoma / diagnosis*
  • Lymphoma / drug therapy
  • Lymphoma / immunology
  • Lymphoma / pathology
  • Male
  • Treatment Failure
  • Young Adult

Substances

  • Immunoglobulin E