Early Pathological JC Virus Lesions in a Patient without Any MRI-based Indications

A 70-year-old woman with a human T-cell leukemia virus type 1 infection without any focal neurological symptoms showed age-related atherosclerotic changes in the white matter without any suspicious signal changes suggestive of progressive multifocal leukoencephalopathy (PML) based on the findings of...

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Bibliographic Details
Published in:Internal Medicine 2021/04/15, Vol.60(8), pp.1279-1282
Main Authors: Sanjo, Nobuo, Nose, Yurie, Miyamoto, Shouhei, Shishido-Hara, Yukiko, Saito, Tatsuya, Fukuda, Tetsuya, Yamamoto, Kurara, Kobayashi, Daisuke, Yokota, Takanori
Format: Article
Language:English
Subjects:
Age
Aged
Arteriosclerosis
Brain - diagnostic imaging
Case Report
Cerebrospinal fluid
CSF PCR
Demyelination
DNA, Viral
Female
Genomes
Humans
Hybridization
Infections
Internal medicine
JC virus
JC Virus - genetics
Leukoencephalopathy
Leukoencephalopathy, Progressive Multifocal - diagnostic imaging
Lymphocytes T
Magnetic Resonance Imaging
Polymerase chain reaction
Progressive multifocal leukoencephalopathy
Substantia alba
viral infection
Viruses
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Summary:A 70-year-old woman with a human T-cell leukemia virus type 1 infection without any focal neurological symptoms showed age-related atherosclerotic changes in the white matter without any suspicious signal changes suggestive of progressive multifocal leukoencephalopathy (PML) based on the findings of MRI. Viral polymerase chain reaction (PCR) revealed 6,700 copies/mL of the JC virus genome in the cerebrospinal fluid (CSF). An immuno-pathological examination of the autopsied brain revealed JC virus capsid proteins, and in situ hybridization confirmed a JC virus infection, indicating that an active infection begins at the radiologically indistinguishable phase of PML. An early JC virus infection is probably associated with small, scattered demyelinating lesions around the cortico-medullary area of the cortex.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.6040-20