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Progressive Multifocal Leukoencephalopathy in Pediatric Patients: Case Report and Literature Review

Schwenk, Hayden MD, MPH*†; Ramirez-Avila, Lynn MD, MSc†‡; Sheu, Shu-Hsien MD§; Wuthrich, Christian PhD; Waugh, Jeff MD, PhD; Was, Adam MD**; DeGirolami, Umberto MD††; Burchett, Sandra MD, MSc; Koralnik, Igor J. MD; Ahmed, Asim MD

The Pediatric Infectious Disease Journal: April 2014 - Volume 33 - Issue 4 - p e99–e105
doi: 10.1097/INF.0000000000000237
HIV Reports

Progressive multifocal leukoencephalopathy is a rare, demyelinating disease of the central nervous system caused by JC virus. Fewer than 30 cases have been reported in HIV- and non-infected children. We report the case of a 15-year-old girl with progressive multifocal leukoencephalopathy and AIDS who presented with nystagmus, dysarthria and ataxia. Following combined antiretroviral therapy, she developed immune reconstitution inflammatory syndrome, which proved fatal.

From the *Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA; Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA; Division of Pediatric Infectious Diseases, David Geffen School of Medicine at UCLA, Mattel Children’s Hospital, Los Angeles, CA; §Department of Pathology, Brigham and Women’s Hospital; Department of Neurology, Beth Israel Deaconess Medical Center; Department of Neurology, Boston Children’s Hospital, Boston, MA; **Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; ††Department of Pathology, Boston Children’s Hospital, Boston, MA.

Accepted for publication December 2, 2013.

This work was supported in part by the National Institute of Allergy and Infectious Diseases T32 AI 007433 (L.R.); Agency for Healthcare Research and Quality T32 HS 019485-01; National Institute of Child Health and Human Development T32 HD 055148-02 (L.R.), R56 NS 041198, R01 NS 047029, R01 NS 074995 and K24 NS 060950 (I.J.K.). The authors have no other funding or conflicts of interest to disclose

H.S., L.R.-A. and A.A. are first co-authors of this study

Address for correspondence: Hayden Schwenk, MD, MPH, Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, 300 Pasteur Dr., Room G312, Stanford, CA, 94305. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.