Progressive Multifocal Leukoencephalopathy as the First Manifestation of AIDS: A Rare Case Report

Abstract

Introduction: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by the JC virus (JCV). Case Presentation: A 47-year-old woman with no history of any underlying diseases was hospitalized at our center with a loss of consciousness and aphasia. The investigation of the patient's history revealed that she had been hospitalized in another hospital a month earlier due to right hemiparesis and dysarthria. Brain imaging was repeated that revealed demyelinating lesions. The laboratory studies showed a positive human immunodeficiency virus (HIV) serology. The polymerase chain reaction (PCR) of the cerebrospinal fluid (CSF) for JCV turned out positive and the diagnosis of PML was established. Conclusions: Progressive multifocal leukoencephalopathy should always be considered as an important differential diagnosis in patients with demyelinating brain lesions and HIV testing should be considered in these patients, as well.

John Cunningham Virus and Progressive Multifocal Leukoencephalopathy: A Falsely Played Diagnosis

“…The disease seems not to affect the peripheral nervous system, and spinal cord as well as optic nerve involvement are believed to be rare [9,69,70]. In rare cases, PML may be the first manifestation of AIDS [71]. The disease can even be manifested as unilateral sensorineural hearing loss, and monoparesis or hemiparesis and dysphasia can be some other initial clinical symptoms [72,73].…”