JC polyomavirus granule cell neuronopathy in a patient treated with rituximab.

Abstract:

IMPORTANCE:Progressive multifocal leukoencephalopathy results from lytic infection of the glia by the JC polyomavirus (JCV); JCV granule cell neuronopathy is caused by infection with a mutated form of JCV, leading to a shift in viral tropism from the glia to cerebellar granule cells. This shift results in a clinical syndrome dominated by progressive cerebellar dysfunction that might elude standard diagnostic workup strategies for ataxia. OBSERVATIONS:We present the case report of a patient receiving long-term rituximab therapy who developed progressive cerebellar ataxia and marked isolated cerebellar degeneration. This syndrome resulted from JCV granule cell neuronopathy associated with a novel JCV mutation. CONCLUSIONS AND RELEVANCE:New onset or worsening of isolated cerebellar ataxia in patients being treated with rituximab or natalizumab warrants early assessment for JCV infection.

journal_name

JAMA Neurol

journal_title

JAMA neurology

authors

Dang L,Dang X,Koralnik IJ,Todd PK

doi

10.1001/jamaneurol.2013.4668

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

487-9

issue

4

eissn

2168-6149

issn

2168-6157

pii

1827550

journal_volume

71

pub_type

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