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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

Spacek, Lisa A. "Progressive Multifocal Leukoencephalopathy (PML)." Johns Hopkins HIV Guide, 2015. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545172/all/Progressive_multifocal_leukoencephalopathy__PML_.
Spacek LA. Progressive multifocal leukoencephalopathy (PML). Johns Hopkins HIV Guide. 2015. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545172/all/Progressive_multifocal_leukoencephalopathy__PML_. Accessed August 19, 2019.
Spacek, L. A. (2015). Progressive multifocal leukoencephalopathy (PML). In Johns Hopkins HIV Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545172/all/Progressive_multifocal_leukoencephalopathy__PML_
Spacek LA. Progressive Multifocal Leukoencephalopathy (PML) [Internet]. In: Johns Hopkins HIV Guide. ; 2015. [cited 2019 August 19]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545172/all/Progressive_multifocal_leukoencephalopathy__PML_.
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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 -