Progressive multifocal leukoencephalitis in a patient with sarcoidosis on hydroxychloroquine with negative cerebrospinal fluid testing for the John Cunningham virus

作     者：Ovais Inamullah Casey Farin Linh Tran Roger McLendon Mark Skeen Joel Morgenlander 

作者机构：Neurology DepartmentDuke University HospitalDurhamNC27705USA Child Neurology DepartmentDuke University HospitalDurhamNC27705USA Pathology DepartmentDuke University HospitalDurhamNC27705USA 

出 版 物：《Neuroimmunology and Neuroinflammation》 (神经免疫与神经炎症（英文版）)

年 卷 期：2018年第5卷第1期

页      面：18-24页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Progressive multifocal leukoencephalopathy sarcoidosis hydroxychloroquine neuroimmunology 

摘      要：Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the John Cunningham (JC) virus typically seen in immuno-compromised patients. Several drugs that suppress that immune system have already been known to cause PML such as natalizumab and rituximab. We present a patient with sarcoidosis who develops PML in the rare setting of minimal immunosuppression with only hydroxychloroquine. There was significant delay in the diagnosis due to negative cerebrospinal fluid testing for JC virus and concern for neuro-sarcoidosis, but eventually a diagnosis of PML was made via brain biopsy.