Spinal cord involvement in progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome

J Neurovirol. 2024 Apr;30(2):208-213. doi: 10.1007/s13365-024-01213-y. Epub 2024 May 22.

Abstract

Progressive multifocal leukoencephalopathy (PML) is an opportunistic infectious demyelinating disease of the central nervous system caused by JC polyomavirus predominantly affecting immunocompromised individuals. Nowadays, HIV, hematological malignancies and iatrogenic immune suppression account for most PML cases. For unknown reasons, spinal cord is classically protected from PML lesions. Here, we report the course of a patient harboring spinal cord lesions in the context of PML with immune reconstitution inflammatory syndrome and review the eight other cases reported in the literature so far. Then, we discuss the evolving spectrum of PML over recent years, potentially making its diagnosis more challenging.

Keywords: IRIS; JC virus; Maraviroc; PML; Spinal cord lesions.

Publication types

  • Case Reports
  • Review

MeSH terms

  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • HIV Infections / virology
  • Humans
  • Immune Reconstitution Inflammatory Syndrome* / drug therapy
  • Immune Reconstitution Inflammatory Syndrome* / immunology
  • Immune Reconstitution Inflammatory Syndrome* / pathology
  • Immune Reconstitution Inflammatory Syndrome* / virology
  • JC Virus* / immunology
  • JC Virus* / pathogenicity
  • Leukoencephalopathy, Progressive Multifocal* / drug therapy
  • Leukoencephalopathy, Progressive Multifocal* / immunology
  • Leukoencephalopathy, Progressive Multifocal* / pathology
  • Leukoencephalopathy, Progressive Multifocal* / virology
  • Magnetic Resonance Imaging
  • Spinal Cord* / diagnostic imaging
  • Spinal Cord* / immunology
  • Spinal Cord* / pathology
  • Spinal Cord* / virology