Progressive Multifocal Leucoencephalopathy (PML) is a rare condition, most often presenting in patients with immune suppression. It is caused by activation of the polyomavirus JC (JCV). This virus infects the majority of people in childhood, but remains inactive unless severe immunosuppression occurs. When activated, the virus causes demyelination of the central nervous system.
Almost all cases of PML develop in patients who are immunocompromised, the most common associated condition being Human Immunodeficiency Virus (HIV). Only 230 cases of PML had been reported before 1984. However, at the beginning of the HIV epidemic, the number of cases of PML increased significantly, with 5% of HIV patients developing the condition. Other commonly associated conditions are haematological malignancies and solid organ tumours. PML has also occurred in transplant recipients and in patients taking immunosuppressive medications. There are few case reports of patients developing PML without any of the above conditions.
Download the rest of the bulletin Progressive Multifocal Leucoencephalopathy (53) Volume 36 (1): October 19, 2009
The 2009 RGH E-Bulletins are archived here.
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