Predictive value of JC virus PCR in cerebrospinal fluid in the diagnosis of PML

Swinnen, Bart; Saegeman, Veroniek; Beuselinck, Kurt; Wouters, Anke; Cypers, Gert; Meyfroidt, Geert; Schrooten, Maarten

doi:10.1016/j.diagmicrobio.2019.06.011

Cited by 23 publications

(11 citation statements)

References 28 publications

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“…Nevertheless, in immunocompromised renal allograft recipients, JCV can bring about nephropathy and/or PML [ 6 ]. PML occurs mainly in acquired immunodeficiency syndrome (AIDS) patients and less frequently after solid organ or allogeneic hematopoietic stem cell transplantations and in Multiple Sclerosis or Crohn's disease patients treated with immunomodulatory drugs [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Determining host factors contributing to the reactivation of JC virus in kidney transplant recipients

Keykhosravi

Khosravi

Shenagari

et al. 2022

Virol J

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Background and aims The John Cunningham virus (JCV) is the established etiological agent of the polyomavirus-associated nephropathy among renal transplant recipients. In the present study, we aimed to determine the probable predictive factors leading to JCV replication in renal transplant patients. Material and methods Urine and plasma samples were collected from a total of 120 consecutive renal‐transplanted patients without preliminary screening from Jan 2018 to Mar 2019. After DNA extraction, the simultaneous detection and quantification of JCV and BK polyomavirus (BKV) were conducted using a Real-time quantitative PCR method. Moreover, statistical analyses were performed using the statistical software packages, SPSS version 21. Results The prevalence of JCV viruria and viremia among renal transplant recipients were 26 (21.67%) and 20 (16.67%), respectively. A significant association was observed between the JCV and two risk factors, diabetes mellitus (P = 0.002) and renal stones (P = 0.015). The prevalence of JCV viremia among recipients who were grafted near time to sampling was significantly higher (P = 0.02). There was a statistically significant coexistence between BK and JC viruses among our patients (P = 0.029). The frequency of JCV viruria in males was reported almost three times more than in females (P = 0.005). The JCV shedding in urine was significantly associated with the tropical steroids like prednisolone acetate, which have been the standard regimen (P = 0.039). Multivariable analysis revealed duration of post-transplantation (OR, 0.89; P = 0.038), diabetes mellitus (OR, 1.85; P = 0.034), and renal stone (OR 1.10; P = 0.04) as independent risk factors associated with JCV viremia post-renal transplantation. Conclusion It seems that the discovery of potential risk factors, including immunological and non-immunological elements, may offer a possible preventive or therapeutic approach in the JCV disease episodes. The results of this study may also help clarify the probable clinical risk factors involving in progressive multifocal leukoencephalopathy development.

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Section: Introductionmentioning

confidence: 99%

Determining host factors contributing to the reactivation of JC virus in kidney transplant recipients

Keykhosravi

Khosravi

Shenagari

et al. 2022

Virol J

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“…1 JCV load from CSF-PCR may be of more importance than the qualitative result with significantly positive JCV loads (⩾2.7 log copies/mL) shown to confer to high likelihood of PML in those with clinico-radiological features of PML. 7 Demyelination, abnormal oligodendrocytes with giant nuclei, multinucleated astrocytes, foamy macrophages and reactive gliosis are typically seen in the brain specimens of patients with PML. 4,5 Analysis of brain tissue by methods of immunohistochemistry, PCR, electron-microscopy can also detect intraprenchymal JCV.…”

Section: Np34mentioning

confidence: 99%

Progressive multifocal leukoencephalopathy in a patient with occult hypogammaglobulinemia experiencing bilateral visual impairment

Hettipathirannahelage

Wijetilleka

Jewsbury

2021

European Journal of Ophthalmology

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Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, lethal, demyelinating disease classically seen in profoundly immunosuppressed individuals. It is caused by intracerebral infection by John Cunningham polyomavirus (JCV). We report a rare case of PML in a man with presumed immunocompetence at presentation experiencing bilateral painless visual impairment. Case Description: A 60-year-old man with a 3-week history of bilateral painless visual impairment attended our ophthalmology department. Unusually, he navigated around the room well and was able to read 4 of 13 Ishihara test plates in spite of a best-corrected visual acuity of counting fingers at 1 m bilaterally. Slit lamp examination, routine blood tests and optical coherence tomography (OCT) of the maculae and discs were unremarkable. Diffuse hyperintense white matter lesions on T2-weighted magnetic resonance imaging of the brain and detection of JCV within the parietal lobe tissue obtained by biopsy confirmed PML. Additional investigations identified an underlying hypogammaglobulinaemia, which may have initiated PML. He received intravenous immunoglobulin but passed away 2 months after diagnosis. Conclusions: To our knowledge this case is one of only a handful worldwide to describe PML developing in a patient with presumed immunocompetence at presentation – there was no previous history of recurrent, chronic, or atypical infections. There has only been one other report of visual symptoms presenting as the primary complaint. The case illustrates the importance of ruling out organic, central nervous system pathology in patients presenting with visual loss and normal objective visual function tests such as slit lamp examination and OCT.

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“…HSV encephalitis in these patients may present atypically and is associated with poorer outcomes [18,19]. Other viruses in immunocompromised population include cytomegalovirus (CMV), human herpesvirus (HHV)-6 and -7 as well as John Cunningham-virus (JCV) [20]. Non-viral causes of acute encephalitis include Mycobacterium tuberculosis, which may account for 5% of etiologies of acute meningoencephalitis [16].…”

Section: Acute Meningoencephalitismentioning

confidence: 99%