Progressive Multifocal Leukoencephalopathy
PML is a rare, slowly progressive disease of the nervous system. It is caused by a viral infection of oligodendrocytes. These are cells that produce myelin.
PML is caused by a papovavirus, known as JC virus. Most people get this infection in childhood, and it produces no illness. It reactivates later in life in people who have a suppressed immune system (eg, HIV/AIDS]]> ).
The most common risk factor is having HIV/AIDS. PML has rarely been associated with:
- Leukemia]]> and lymphoma
- Prolonged immunosuppression (organ transplant or ]]>cancer]]> patients)
- Chronic steroid therapy
- Rare inherited immunodeficiencies
- ]]>Natalizumab]]> (medication used to treat ]]>multiple sclerosis]]> )—the risk may only occur when also taking other immunosuppressants
If you experience any of these symptoms do not assume it is due to PML. These symptoms may be caused by other conditions. Symptoms progress over weeks and include:
Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Tests may include:
While there is no cure for PML, talk with your doctor about the best treatment plan for you. If you stopped taking HIV medications, taking them again may be helpful. Ask your doctor.
National Organization for Rare Disorders
Canadian AIDS Society
Canadian Organization for Rare Disorders
NINDS progressive multifocal leukoencephalopathy information page. National Institute of Neurological Disorders and Stroke website. Available at http://www.ninds.nih.gov/disorders/pml/pml.htm . Accessed September 30, 2005.
Progressive multifocal leukoencephalopathy. EBSCO DynaMed website. Available from DynaMed: http://www.ebscohost.com/dynamed . Updated January 10, 2008. Accessed February 23, 2008.
Progressive multifocal leukoencephalopathy. Medline Plus Medical Encyclopedia website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000674.htm . Accessed September 30, 2005.
Last reviewed January 2009 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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