Inflammatory progressive multifocal leukoencephalopathy in human immunodeficiency virus–negative patients
Article first published online: 27 FEB 2007
Copyright © 2007 American Neurological Association
Annals of Neurology
Volume 62, Issue 1, pages 34–39, July 2007
How to Cite
Huang, D., Cossoy, M., Li, M., Choi, D., Taege, A., Staugaitis, S. M., Rehm, S. and Ransohoff, R. M. (2007), Inflammatory progressive multifocal leukoencephalopathy in human immunodeficiency virus–negative patients. Ann Neurol., 62: 34–39. doi: 10.1002/ana.21085
- Issue published online: 27 JUL 2007
- Article first published online: 27 FEB 2007
- Manuscript Accepted: 22 DEC 2007
- Manuscript Revised: 20 DEC 2007
- Manuscript Received: 30 AUG 2007
- Research Projects Committee, Cleveland Clinic. Grant Number: RPC2005-1095
- NIH. Grant Number: NINDS, PO1 NS38667
Inflammatory progressive multifocal leukoencephalopathy (iPML) with enhancing magnetic resonance imaging (MRI) lesions and leukocyte infiltration occurs in human immunodeficiency virus (HIV)–infected individuals after highly active antiretroviral therapy (HAART) treatment. MRI diagnostic criteria for PML suggest that iPML does not occur in HIV-negative individuals.
We studied pathologically proved PML (12 by biopsy, 9 with MRI, 32 at autopsy).
HIV-negative (2/5) and -positive (2/4) PML patients had enhancing MRI lesions, correlated with CD3+ lymphocyte infiltration. Inflammatory infiltrates occurred in the majority of HIV-negative (7/8) and HIV-positive/HAART (17/20) cases (p > 0.2), but in only 2 of 16 HIV-positive/non-HAART cases (p < 0.001).
iPML showed radiographic and pathological similarity in HIV-positive/HAART and HIV-negative patients. HIV-negative iPML necessitates further consideration of MRI criteria for PML. Ann Neurol 2007