Table of Contents
Washington University Experience | INFECTION | Viruses | PML (JC Virus) | PML - IRIS | 2A0 Case 2 History
Case 2 History ---- This patient was a 73 year old woman with a PMH of chronic rheumatoid arthritis and hypertension, who had been receiving low dose prednisone, leflunomide, and Plaquenil for many years. She was recently started on rituximab and soon developed word-finding difficulties with right sided weakness prompting MRI which revealed a non-enhancing left parietal white matter lesion. She was also noted to have rotary nystagmus and gait instability. JC virus was demonstrated in CSF by PCR. She was placed on mefloquine for PML but deterioration continued. Her MRI showed significant increase in lesions especially in the cerebellum, left frontal and temporal lobes, right parietal and occipital lobes. PML progressed and she expired in hospice.
