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Case No. 704
2024-11-01~2024-11-30
출제자 : 김슬기
Hit : 592
| Period | 2024-11-01~2024-11-30 |
|---|---|
| Diagnosis | Progressive multifocal leukoencephalopathy |
| Gender |
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| Age | 54 |
| Clinical information | 54세 여자 Motor aphasia, multiple myeloma로 PBSCC 및 ASCT with BUMEL 치료 후 F/U |
| Discussion | 진단: Progressive multifocal leukoencephalopathy Definition & Types: • Demyelinating disease caused by JC virus reactivation in immunocompromised patients • Three forms: o Standard PML in immunocompromised state o PML-s-IRIS: simultaneous with immune reconstitution o PML-d-IRIS: worsening of existing PML during immune recovery Key Features: • Common in AIDS patients (CD4 <100 cells/μL) • Also seen in: o Post-transplant patients o Cancer patients o Autoimmune disease patients o Patients on specific immunosuppressive therapies Clinical Presentation: • Various neurological symptoms • Common symptoms: altered mental status, motor deficits, ataxia, visual problems • Typically spares optic nerve and spinal cord Imaging Characteristics: • MRI: Multifocal, asymmetric white matter lesions o T1: hypointense o T2: hyperintense with "Milky Way sign" o Usually no enhancement (except in IRIS cases) • CT: Asymmetric low attenuation in white matter |
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