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Resident PGY 1
Henry Ford Hospital
Progressive multifocal leukoencephalopathy (PML) is a rare, fatal sub-acute demyelinating disease of subcortical white matter most commonly caused by reactivation of the ubiquitous Jon Cunningham virus (JCV). PML has been documented in patients with immune-suppressed conditions, including but not limited to organ transplantation, HIV/AIDS, malignancy, and auto-immune diseases. We describe the case of a 65-year old male who presented with anomia, confusion, left upper extremity tremor, and generalized weakness 3 years after undergoing bilateral lung transplantation for idiopathic pulmonary fibrosis. Cerebrospinal fluid (CSF) and MRI findings confirmed the diagnosis of PML. We also review other reported cases as well as available treatment modalities for this rare condition. Lung transplantation has become the standard of care in patients with end-stage chronic respiratory failure. As the prevalence of lung transplantation increases worldwide, more data is becoming available regarding long-term outcomes. Our findings suggest that neurological symptoms and white matter changes on imaging should prompt high clinical suspicion for PML in this patient population.
Stec, Natalie and Tancer, Stephanie B., "Anomia in a Lung Transplant Recipient" (2020). Case Reports. 13.