Progressive multifocal leukoencephalopathy following heightened immunosuppression after lung transplant.

Journal Article (Journal Article)

Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the central nervous system caused by the JC virus that occurs in the setting of immunosuppression. A 38-year-old female lung transplant recipient at our institution received treatment for episodes of acute rejection with steroids, anti-thymocyte globulin and alemtuzumab, in addition to maintenance immunosuppression. She was diagnosed with PML 13 months after the last episode of rejection, for which she had received alemtuzumab. Despite attempted treatment with cidofovir followed by mirtazapine, PML progressed, and she ultimately died of an acute pulmonary infection and respiratory failure. We provide a detailed clinical and radiographic description of PML in a lung transplant patient and highlight its potential relationship to intensive immunosuppression, as the disease developed in the setting of markedly reduced CD4 counts.

Full Text

Duke Authors

Cited Authors

  • Waggoner, J; Martinu, T; Palmer, SM

Published Date

  • April 2009

Published In

Volume / Issue

  • 28 / 4

Start / End Page

  • 395 - 398

PubMed ID

  • 19332268

Pubmed Central ID

  • PMC3727631

Electronic International Standard Serial Number (EISSN)

  • 1557-3117

Digital Object Identifier (DOI)

  • 10.1016/j.healun.2008.12.010


  • eng

Conference Location

  • United States