PMID- 26063110
OWN - NLM
STAT- MEDLINE
DCOM- 20160329
LR  - 20181202
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2015
DP  - 2015 Jun 10
TI  - Immune reconstitution inflammatory syndrome in a patient with progressive 
      multifocal leukoencephalopathy.
LID - 10.1136/bcr-2014-207325 [doi]
LID - bcr2014207325
AB  - Progressive multifocal leukoencephalopathy (PML) is a severe opportunistic 
      infection of the central nervous system. A 52-year-old man with HIV infection, 
      recently started on antiretroviral therapy, presented with symptoms of mental 
      cloudiness, blurry vision and ataxia. MRI of the brain showed nodular 
      perivascular space enhancement with surrounding vasogenic oedema and midline 
      shift. A lumbar puncture revealed non-inflammatory cerebrospinal fluid and was 
      positive for JC virus. As the patient developed worsening symptoms in the setting 
      of initiation of antiretroviral therapy with immune recovery, a diagnosis of JC 
      virus-associated immune reconstitution inflammatory syndrome (IRIS) was made. 
      With recent literature on the use of CCR5 antagonist maraviroc in PML, our 
      patient was started on maraviroc and noted to have improvement in PML IRIS. This 
      is the first case of an HIV-positive patient successfully treated for PML IRIS 
      with maraviroc, as verified by our literature review; also, our case has clinical 
      implications in improving outcome in PML IRIS.
CI  - 2015 BMJ Publishing Group Ltd.
FAU - Shahani, Lokesh
AU  - Shahani L
AD  - Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
FAU - Shah, Minal
AU  - Shah M
AD  - Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
FAU - Tavakoli-Tabasi, Shahriar
AU  - Tavakoli-Tabasi S
AD  - Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA 
      Department of Medicine, Michael E DeBakey Veterans Affairs Medical Center, 
      Houston, Texas, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20150610
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (CCR5 Receptor Antagonists)
RN  - 0 (Cyclohexanes)
RN  - 0 (Triazoles)
RN  - MD6P741W8A (Maraviroc)
SB  - IM
MH  - CCR5 Receptor Antagonists/*therapeutic use
MH  - CD8-Positive T-Lymphocytes/*immunology/virology
MH  - Cyclohexanes/*therapeutic use
MH  - Disease Progression
MH  - HIV Infections/complications/drug therapy/*immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnosis/drug therapy/immunology
MH  - JC Virus/*immunology
MH  - Leukoencephalopathy, Progressive Multifocal/*diagnosis/drug therapy/immunology
MH  - Male
MH  - Maraviroc
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Triazoles/*therapeutic use
PMC - PMC4480113
EDAT- 2015/06/13 06:00
MHDA- 2016/03/30 06:00
PMCR- 2017/06/10
CRDT- 2015/06/12 06:00
PHST- 2015/06/12 06:00 [entrez]
PHST- 2015/06/13 06:00 [pubmed]
PHST- 2016/03/30 06:00 [medline]
PHST- 2017/06/10 00:00 [pmc-release]
AID - bcr-2014-207325 [pii]
AID - 10.1136/bcr-2014-207325 [doi]
PST - epublish
SO  - BMJ Case Rep. 2015 Jun 10;2015:bcr2014207325. doi: 10.1136/bcr-2014-207325.