Progressive multifocal leukoencephalopathy in a renal transplant patient

Lin, Tsu Chen; Wu, Mei Yi; Luh, Hui-Tzung; Lin, Sheng-Fuu; Lin, Chien Min; Tseng, Yi‐Ping; Liu, Yung Ching; Wu, Mai Szu

doi:10.1007/s13365-019-00749-8

Cited by 2 publications

(1 citation statement)

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“…The JCV normal sites of latency, including the kidney and bone marrow, may result in the virus reaction after immunosuppression for transplantation. PML is a rare complication following renal transplantation with an incidence of 0.027% in transplant recipients and is typically associated with high JCV viral loads in the CSF [58,59]. In addition, there have been only a few cases of nephropathy attributed to JCV.…”

Section: Transplant Patientsmentioning

confidence: 99%

JC Polyomavirus and Transplantation: Implications for Virus Reactivation after Immunosuppression in Transplant Patients and the Occurrence of PML Disease

Hildreth

Alcendor

2021

Transplantology

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The JC polyomavirus (JCPyV/JCV) is a member of the Polyomaviridae family and is ubiquitious in the general population, infecting 50–80% of individuals globally. A primary infection with JCV usally results in an asymptomatic, persistent infection that establishes latency in the renourinary tract. Reactivation from latency via iatrogenic immununosuppression for allograft transplantation may result in organ pathology and a potential life-threatening neuropathological disease in the form of progressive multifocal leukoencephalopathy (PML). Currently, no treatment exists for PML, a rare complication that occurs after transplantation, with an incidence of 1.24 per 1000 persons a year among solid organ transplant patients. PML is also observed in HIV patients who are immununosuppressed and are not receiving antiretroviral therapy, as well as individuals treated with biologics to suppress chronic inflammatory responses due to multiple sclerosis, Crohn’s disease, non-Hodgkin’s lymphoma, rheumatoid arthritis, and other autoimmune-mediated hematological disorders. Here, we describe the proposed mechanisms of JCV reactivation as it relates to iatrogenic immunosuppression for graft survival and the treatment of proinflammatory disease, such as biologics, proposed trafficking of JCV from the renourinary tract, JCV central nervous system dissemination and the pathology of PML in immunosuppressed patients, and potential novel therapeutics for PML disease.

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Section: Transplant Patientsmentioning

confidence: 99%