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Fulminant JC virus encephalopathy with productive infection of cortical pyramidal neurons
Author(s) -
Wüthrich Christian,
Dang Xin,
Westmoreland Susan,
McKay John,
Maheshwari Atul,
Anderson Matthew P.,
Ropper Allan H.,
Viscidi Raphael P.,
Koralnik Igor J.
Publication year - 2009
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21619
Subject(s) - progressive multifocal leukoencephalopathy , pathology , jc virus , leukoencephalopathy , brain biopsy , white matter , cerebrospinal fluid , fulminant , encephalopathy , medicine , pyramidal cell , biology , virus , virology , biopsy , immunology , neuroscience , magnetic resonance imaging , disease , radiology , hippocampal formation
The polyomavirus JC (JCV) is the causative agent of progressive multifocal leukoencephalopathy and of JCV granule cell neuronopathy. We present a human immunodeficiency virus–negative patient who experienced development of multiple cortical lesions, aphasia, and progressive cognitive decline after chemotherapy for non–small‐cell lung cancer. Brain biopsy and cerebrospinal fluid polymerase chain reaction demonstrated JCV, and she had a rapidly fatal outcome. Postmortem analysis showed diffuse cortical lesions and areas of necrosis at the gray–white junction. Immunostaining showed a productive JCV infection of cortical pyramidal neurons, confirmed by electron microscopy, with limited demyelination. This novel gray matter syndrome expands the scope of JCV clinical presentation and pathogenesis. Ann Neurol 2009;65:742–748