Mostrar el registro sencillo del ítem

AutorLima, Marco A.
AutorBernal-Cano, Francisco
AutorClifford, David B.
AutorGandhi, Rajesh
AutorKoralnik, Igor J.
Fecha de acceso2019-12-03T15:07:36Z
Fecha de disponibilización2019-12-03T15:07:36Z
Fecha de publicación2010
ReferenciaLIMA, Marco A. et al. Clinical outcome of long-term survivors of progressive multifocal leukoencephalopathy. Journal of Neurology, Neurosurgery and Psychiatry, v. 81, n. 11, p. 1288-1291, Nov. 2010.pt_BR
ISSN0022-3050pt_BR
URIhttps://www.arca.fiocruz.br/handle/icict/37549
DescripciónMarco A. Lima. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.pt_BR
Idiomaengpt_BR
EditorBMJ Publishing Grouppt_BR
Derechos de autoropen accesspt_BR
TítuloClinical outcome of long-term survivors of progressive multifocal leukoencephalopathypt_BR
Tipo del documentoArticlept_BR
DOI10.1136/jnnp.2009.179002
Resumen en InglésProgressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease of the brain caused by the polyomavirus JC (JCV) in immunosuppressed people. There is no cure for PML but one-year survival has increased from 10% to 50% in HIV-infected individuals treated with highly active antiretroviral therapy (HAART). We describe herein the clinical outcome of 24 PML patients whose survival exceeded 5 years, with a mean follow-up of 94.2 months (range 60–188 months). Of all patients, only 2 were females including one who had non-Hodgkin’s lymphoma and was HIV-negative. All 23 HIV-positive patients received HAART, and additional experimental therapies were not associated with a better clinical outcome. Marked neurological improvement occurred in 4/24(17%) of patients, while 11/24 (46%) had partial improvement and 9/24(37%) remained stable. By the end of the period of observation, 8/24(33%) of patients had no significant disability despite persistent symptoms (modified Rankin disability scale (MRDS) =1), 6/24(25%) had slight disability and were living independently (MRDS=2), 5/24(21%) were moderately disabled, requiring some help during activities of daily living (MRDS=3) and 5/24(21%) had moderately severe disability, requiring constant help or institutionalization (MRDS=4). Patients with cerebellar lesions tended to have a worse clinical outcome. MRI showed leukomalacia with ventricular enlargement secondary to destruction of the white matter at the site of previous PML lesions, and focal areas of subcortical atrophy with preservation of the cortical ribbon. Of 20 patients tested, 19(95%) had detectable CD8+ cytotoxic T-lymphocytes against JCV in their blood. In absence of a specific treatment, immunotherapies aiming at boosting the cellular immune response against JCV may improve the prognosis of PML.pt_BR
AfiliaciónHarvard Medical School. Beth Israel Deaconess Medical Center. Department of Neurology. Division of Viral Pathogenesis. Boston, MA, USA.pt_BR
AfiliaciónHarvard Medical School. Beth Israel Deaconess Medical Center. Department of Neurology. Division of Viral Pathogenesis. Boston, MA, USA.pt_BR
AfiliaciónWashington University. School of Medicine. Departments of Neurology and Medicine. St. Louis, MO, USA.pt_BR
AfiliaciónMassachusetts General Hospital. Infectious Diseases Division. Boston, MA, USA / Harvard Medical School. Boston, MA, USA / Ragon Institute. Cambridge, MA, USA.pt_BR
AfiliaciónHarvard Medical School. Beth Israel Deaconess Medical Center. Department of Neurology. Division of Viral Pathogenesis. Boston, MA, USA.pt_BR
Palavras clave en InglêsProgressive multifocal leukoencephalopathypt_BR
Palavras clave en InglêsClinical outcomept_BR
Palavras clave en InglêsLong-term survivorspt_BR
e-ISSN1468-330X
Fecha de embargo2020-12-03


Ficheros en el ítem

application/pdf
Nombre:
ve_Lima_Marco_etal_INI_2010.pdf
Tamaño:
399.4Kb
Formato:
application/
Ver/Abrir

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem