PML can occur in normal or only mildly immune-suppressed patients.
Progressive multifocal leukoencephalopathy (PML) is a devastating neurological disease that is a recognized complication of AIDS and can be seen with other forms of immunosuppression, most typically medication-induced. Although an estimated 85% of adults have been infected by the causative agent (JC virus), PML is thought to be essentially restricted to the immune deficient. In this study, investigators report on five patients with either minimal or no immunosuppression who developed PML, and they review relevant case reports culled from a literature search.
The authors identified PML presentations in two patients with alcoholic cirrhosis, one with dermatomyositis, and two with unexplained CD4+ T-cell depletion. Four of the patients develope…