![]() Patchy and punctuate gadolinium enhancement was identified over cerebellum and both cerebral hemispheres. She had not received other immunosuppressive or immunoregulatory drugs.īrain MRI showed several white matter lesions on T2- and fluid-attenuated inversion recovery–weighted sequences involving brainstem, cerebellum, and cerebral hemispheres ( figure). Four years before presentation, the aHUS had been treated with plasmapheresis and prednisone 1 mg/kg per day for 3 months. She had been treated with thymoglobulin 1.5 mg/kg per day the first 5 days after her transplant. After the transplant 8 months before, her treatment also included tacrolimus 5 mg bid and prednisone 10 mg every day. Four months before the transplant, and 1 year before neurologic presentation, she had been treated with eculizumab 1,200 mg every 14 days to prevent an aHUS relapse. Bilateral facial and palatal palsy, moderate left leg weakness, and ataxia appeared gradually and progressed quickly a few days prior to admission. We report the novel finding of PML in a patient receiving eculizumab.Case report.Ī 26-year-old woman with a double intestinal-kidney transplant for aHUS and intestinal lymphangiectasia complained of unsteady gait and diplopia for 2 weeks. 2 Eculizumab can impair neutrophil and monocyte functions and predispose to encapsulated bacteria infections. It has been shown to be effective in the treatment of paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome (aHUS). 1Įculizumab is a first-in-class humanized monoclonal antibody developed to target the cleavage of C5, preventing the release of C5a and activation of the terminal complement pathway. In the context of immunosuppression, JCV can reactivate and spread to brain infecting oligodendrocytes. Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the CNS caused by reactivation of the polyomavirus JC (JCV).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |