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    Progressive multifocal leukoencephalopathy (PML)

    Lisa A. Spacek, M.D., Ph.D.
    Progressive multifocal leukoencephalopathy (PML) is a topic covered in the Johns Hopkins HIV Guide.

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    PATHOGENS

    • JC (after patient "JC" John Cunningham) virus is a ubiquitous neurotropic ds-DNA polyomavirus. Infects oligodendrocytes and astrocytes.
    • Primarily affects deep and subcortical white matter of brain and can expand into cortical gray matter. Rarely involves spinal cord. Spares optic nerve.[2]
    • Virus resides in extraneural reservoirs, i.e., lymphoid tissue, kidney, and bone marrow. Excreted in urine of healthy individuals and those with PML.[5]
    • Seroprevalence of 70-80%, antibody not protective, those with deficient cellular response, e.g. HIV/AIDS, organ transplantation, hematologic malignancies, and those receiving immunosuppressive therapies, are at risk for PML.[2]

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    Last updated: October 31, 2015

    Citation

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    TY - ELEC T1 - Progressive multifocal leukoencephalopathy (PML) ID - 545172 A1 - Spacek,Lisa,M.D., Ph.D. Y1 - 2015/10/31/ BT - Johns Hopkins HIV Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545172/all/Progressive_multifocal_leukoencephalopathy__PML_ DB - Johns Hopkins Guide DP - Unbound Medicine ER -