PMID- 35001250
OWN - NLM
STAT- MEDLINE
DCOM- 20220510
LR  - 20220619
IS  - 1538-2443 (Electronic)
IS  - 1355-0284 (Linking)
VI  - 28
IP  - 1
DP  - 2022 Feb
TI  - Atypical presentations and course of JC virus infection.
PG  - 183-186
LID - 10.1007/s13365-021-01031-6 [doi]
AB  - There is increasing evidence that the spectrum of human polyomavirus 2 (JCV) CNS 
      disease includes novel syndromes other than progressive multifocal 
      leukoencephalopathy (PML), the appreciation of which is increasingly important in 
      the context of MS therapies and immunodeficiency states. Our objective is to 
      describe unusual presentations of JCV infection to heighten clinician 
      awareness. We describe three case reports of various PML presentations. Firstly a 
      56-year-old HIV positive male with decades of viral suppression and normal immune 
      function presented with 1 month of non-specific headache that spontaneously 
      resolved despite an MRI showing a new area of PML and CSF being JC DNA + . He had 
      had two similar episodes in 2013 and 2014 with MRI scans consistent with PML, 
      CSF, JCV, and PCR positivity once and brain biopsy-positive twice. Another 
      61-year-old male presented with subacute binocular vision loss and was found to 
      have newly diagnosed HIV and JCV DNA detected in CSF. MRI brain only demonstrated 
      symmetrical chiasmo-hypothalamic enhancement. There has been some improvement 
      with combination antiretroviral therapy and corticosteroids for immune 
      reconstitution inflammatory syndrome (IRIS). Thirdly, a 65-year-old male 
      presented with subacute progressive confusion and behavioural disturbance, one 
      year post-bilateral lung transplantation. MRI brain demonstrated no evidence of 
      PML but CSF on three occasions demonstrated a progressively increasing JCV DNA 
      load. Despite reduction in his immunosuppression, the patient developed profound 
      encephalopathy without localising features leading to death two months later. 
      These cases emphasise the atypical presentations of JCV: chronic relapsing, 
      unusual symmetrical visual pathway disease, and non-localising encephalopathy 
      without MRI evidence of PML.
CI  - (c) 2022. Journal of NeuroVirology, Inc.
FAU - Chatterton, Sophie
AU  - Chatterton S
AUID- ORCID: 0000-0003-4296-9285
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Department of Neurology, St Vincent's Hospital, 390 Victoria Road, Sydney NSW, 
      2010, Australia.
FAU - Dwyer, Liam
AU  - Dwyer L
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Department of Neurology, St Vincent's Hospital, 390 Victoria Road, Sydney NSW, 
      2010, Australia.
FAU - Thomson, Claire
AU  - Thomson C
AD  - Department of Thoracic Medicine and Lung Transplant, St Vincent's Hospital, 
      Sydney, Australia.
FAU - Plit, Marshall
AU  - Plit M
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Department of Thoracic Medicine and Lung Transplant, St Vincent's Hospital, 
      Sydney, Australia.
AD  - Faculty of Medicine, Charles Sturt University, Bathurst, Australia.
FAU - Longmuir, Henrietta
AU  - Longmuir H
AD  - Department of Neurology, St Vincent's Hospital, 390 Victoria Road, Sydney NSW, 
      2010, Australia.
FAU - Chaganti, Joga
AU  - Chaganti J
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Department of Medical Imaging, St Vincent's Hospital, Sydney, Australia.
FAU - Barnett, Yael
AU  - Barnett Y
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
AD  - Department of Medical Imaging, St Vincent's Hospital, Sydney, Australia.
FAU - Brew, Bruce
AU  - Brew B
AD  - St Vincent's Clinical School, University of New South Wales, Sydney, Australia. 
      bruce.brew@svha.org.au.
AD  - Department of Neurology, St Vincent's Hospital, 390 Victoria Road, Sydney NSW, 
      2010, Australia. bruce.brew@svha.org.au.
AD  - Neuroscience Research Australia, Sydney, Australia. bruce.brew@svha.org.au.
AD  - Faculty of Medicine, University of Notre Dame, Sydney, Australia. 
      bruce.brew@svha.org.au.
AD  - Peter Duncan Neurosciences Unit, St Vincent's Centre for Applied Medical 
      Research, Sydney, Australia. bruce.brew@svha.org.au.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20220109
PL  - United States
TA  - J Neurovirol
JT  - Journal of neurovirology
JID - 9508123
RN  - 0 (DNA, Viral)
SB  - IM
MH  - Aged
MH  - Antiretroviral Therapy, Highly Active
MH  - DNA, Viral/genetics
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/complications/drug therapy
MH  - *JC Virus/genetics
MH  - *Leukoencephalopathy, Progressive Multifocal/diagnostic imaging/drug therapy
MH  - Male
MH  - Middle Aged
OTO - NOTNLM
OT  - Demyelination
OT  - JCV
OT  - Multiple sclerosis
OT  - PML
EDAT- 2022/01/11 06:00
MHDA- 2022/05/11 06:00
CRDT- 2022/01/10 06:29
PHST- 2021/06/04 00:00 [received]
PHST- 2021/11/27 00:00 [accepted]
PHST- 2021/06/04 00:00 [revised]
PHST- 2022/01/11 06:00 [pubmed]
PHST- 2022/05/11 06:00 [medline]
PHST- 2022/01/10 06:29 [entrez]
AID - 10.1007/s13365-021-01031-6 [pii]
AID - 10.1007/s13365-021-01031-6 [doi]
PST - ppublish
SO  - J Neurovirol. 2022 Feb;28(1):183-186. doi: 10.1007/s13365-021-01031-6. Epub 2022 
      Jan 9.