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Washington University Experience | INFECTION | Viruses | PML (JC Virus) | PML - IRIS | 6A0 Case 6 History - Copy
Case 6 History ---- This patient was a healthy young man who was well until August of 2013. He started with subtle complaints including lack of concentration, visual symptoms with trouble focusing, forgetfulness and mild headaches. An MRI of the brain obtained showed a white matter lesion in the left occipital region and he was admitted for evaluation. He was subjected to a battery of tests including those for numerous infectious organisms with no identification of a single agent at that time. Tests also performed include absolute CD4 181 (N 720-1348) count which was selective for CD4+ lymphopenia. When no certain diagnosis was established, brain biopsy was performed which demonstrated PML with marked inflammation. Repeat MRI scan showed possible increased involvement of corpus callosum but for the most part was stable. A second, tentative diagnosis of systemic sarcoid was made on the basis of his chest X-ray appearance and unexplained CD4+ lymphopenia.
