HOME > Weekly Case > Weekly Case
Weekly Case
종결
Case No. 428
2016-12-01~2016-12-31
출제자 : 배윤정
Hit : 399
| Period | 2016-12-01~2016-12-31 |
|---|---|
| Diagnosis | Progressive multifocal leukoencephalopathy (PML) |
| Clinical information | F/71 PI> Progressive gait ataxia (2MA), dizziness Long-term steroid user 사진 위 2장-2016년 8월 --> 아래 2장 2016년 12월 FU |
| Discussion | Progressive multifocal leukoencephalopathy (PML) MRI: Multifocal T2 hyperintense lesions involving cerebellum and brainstem, progression between 2 months Lab: Serum and CSF JC virus PCR positive Low CD4 count 21% Progressive multifocal leukoencephalopathy (PML) -JC polyomavirus infects oligodendrocytes, causes demyelination in immunocompromised patients -Associated with immunosuppression, often AIDS, organ transplant, cancer, chemotherapy, steroid treatment -Imaging a. Multifocal T2 hyperintense demyelinating plaques involving subcortical white matter, extend to deep white matter b. Gray matter often spared until late stage c. Generally no contrast enhancement or mass effect d. Late: Confluent white matter disease, cystic changes e. Propensity for frontal and parietooccipital region, thalamus, and basal ganglia, may involve brainstem and cerebellum (but, rarely lesions are only in posterior fossa) f. May be solitary, multifocal, or widespread confluent -Highly active antiretrovirus therapy (HAART) reported to improve survival -Differential diagnosis HIV encephalitis, ADEM, acquired CMV, immune reconstitution inflammatory syndrome |
| Correct answer |
Correct Answer
Semi-Correct Answer |