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Progressive multifocal leukoencephalopathy after heart transplantation: 4 years of clinically stable infection on low-dose immunosuppressive therapy
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-5485-1052
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
2017 (English)In: Oxford medical case reports, E-ISSN 2053-8855, Vol. 2017, no 2, p. 15-17Article in journal (Refereed) Published
Abstract [en]

Progressive multifocal leukoencephalopathy (PML), caused by reactivation of JC-virus is a relatively rare complication seen in patients with compromised immune system. There are no evidence-based treatment available and prognosis is poor. Withdrawal of immunosuppressant can result in further neurological deterioration and for patients with solid organ transplantations, fatal graft rejection. We report a 52-year-old women that presented with seizures within 1 month after heart transplantation. Initial diagnosis was vascular disease. After clinical deterioration 10 months after transplantation, further examinations led to the diagnosis. Minimizing tacrolimus, to a concentration of 2 ng/ml, and extensive physical therapy has improved the physical capacity of the patient. The patient has now been clinically stable for 4 years and extended survival for 5 years. This case adds to the limited adult cases of PML within the population of heart transplant recipients and the need for increased awareness to minimize diagnosis delay.

Place, publisher, year, edition, pages
Oxford Academic , 2017. Vol. 2017, no 2, p. 15-17
National Category
Surgery Infectious Medicine
Identifiers
URN: urn:nbn:se:liu:diva-145288DOI: 10.1093/omcr/omx003PubMedID: 28473916OAI: oai:DiVA.org:liu-145288DiVA, id: diva2:1185222
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-05-21Bibliographically approved

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Sundbom, PerHübbert, LailaSerrander, Lena
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