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Visual symptoms after lung transplantation: a case of progressive multifocal leukoencephalopathy
Author(s) -
Ouwens J.P.,
HaaxmaReiche H.,
Verschuuren E.A.M.,
Timens W.,
Steenhuis L.H.,
Boer W.J.,
Bij W.
Publication year - 2000
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1034/j.1399-3062.2000.020106.x
Subject(s) - medicine , progressive multifocal leukoencephalopathy , differential diagnosis , jc virus , immunosuppression , transplantation , autopsy , cerebrospinal fluid , leukoencephalopathy , pathology , lung transplantation , lung , disease , surgery , multiple sclerosis , immunology
After solid organ transplantation, signs and symptoms of the central nervous system may present a diagnostic challenge. A 43‐year‐old patient developed a decrease in vision 15 months after bilateral lung transplantation. The initial diagnosis was a left posterior cataract, but left eye cataract extraction did not improve his vision. Seizures led to investigation of a broader differential diagnosis (cyclosporine intoxication, post‐transplant lymphoproliferative disorder, infectious disease, chronic lymphatic leukemia). The clinical diagnosis of progressive multifocal leukoencephalopathy (PML) was confirmed by demonstration of JC virus in the cerebrospinal fluid and by autopsy findings. Modulation of the immunosuppressive regimen was unsuccessful. This case illustrates that decreased vision in immunocompromised patients may be the first manifestation of PML.