Simultaneous Development of Progressive Multifocal Leukoencephalopathy and Cryptococcal Meningitis during Methotrexate and Infliximab Treatment
-
- Nosaki Yasunobu
- Department of Neurology, Toyohashi Municipal Hospital, Japan
-
- Ohyama Ken
- Department of Neurology, Toyohashi Municipal Hospital, Japan
-
- Watanabe Maki
- Department of Neurology, Toyohashi Municipal Hospital, Japan
-
- Yokoi Takamasa
- Department of Neurology, Toyohashi Municipal Hospital, Japan
-
- Nakamichi Kazuo
- Department of Virology 1, National Institute of Infectious Diseases, Japan
-
- Saijo Masayuki
- Department of Virology 1, National Institute of Infectious Diseases, Japan
-
- Miura Yoshiharu
- Department of Neurology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan
-
- Iwai Katsushige
- Department of Neurology, Toyohashi Municipal Hospital, Japan
Search this article
Abstract
<p>Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by reactivation of the JC virus under an immunosuppressed state. This condition carries a high risk of cryptococcal meningitis. We herein report a 65-year-old woman who simultaneously developed PML and cryptococcal meningitis and presented with bilateral sixth nerve palsy. She had been treated with methotrexate and infliximab for rheumatoid arthritis. Her symptoms improved with antifungal drug treatment and discontinuation of immunosuppression therapy. Although concurrent PML and cryptococcal meningitis is rare, it should be considered in immunosuppressed patients. </p>
Journal
-
- Internal Medicine
-
Internal Medicine 58 (18), 2703-2709, 2019-09-15
The Japanese Society of Internal Medicine
