Visual symptoms after lung transplantation: a case of progressive multifocal leukoencephalopathy
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 extr...
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| Veröffentlicht in: | Transplant infectious disease 2000-03, Vol.2 (1), p.29-32 |
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| container_title | Transplant infectious disease |
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| creator | Ouwens, J.P. Haaxma-Reiche, H. Verschuuren, E.A.M. Timens, W. Steenhuis, L.H. De Boer, W.J. Van Der Bij, W. |
| description | 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. |
| doi_str_mv | 10.1034/j.1399-3062.2000.020106.x |
| format | Article |
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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. 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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.</description><subject>Adult</subject><subject>Autopsy</subject><subject>Brain - pathology</subject><subject>cataract</subject><subject>Cerebellum - pathology</subject><subject>Fatal Outcome</subject><subject>Humans</subject><subject>JC virus</subject><subject>JC Virus - isolation & purification</subject><subject>Leukoencephalopathy, Progressive Multifocal - cerebrospinal fluid</subject><subject>Leukoencephalopathy, Progressive Multifocal - diagnosis</subject><subject>Lung Transplantation</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Postoperative Complications</subject><subject>progressive multifocal leukoencephalopathy</subject><subject>Vision Disorders - etiology</subject><subject>Visual Acuity</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1u1DAURi1ERUvhFZDZsEu4tjN2wgo0lKFSVTblZ2dsx24zdeJgO2Xm7cmQUdmy8pX8fedeHYReEygJsOrttiSsaQoGnJYUAEqgQICXuyfo7PHn6d-5LigV7BQ9T2kLQERTNc_QKSEVbQDEGfr5rUuT8jjt-zGHPmHlso3YT8MtzlENafRqyCp3YXiHFTYqWRwcHmO4jTal7sHifvK5c8HMFG-n-2AHY8c75cOo8t3-BTpxyif78vieo6-fLm7Wn4urL5vL9YerwrC64UXrOKudIVo4aKFeUWNq5qDRwFdcc21h5YyoasIBlCBOa0V0W7VEEzU3K3aO3izc-bRfk01Z9l0y1s_n2zAlKSgHSkkzB5slaGJIKVonx9j1Ku4lAXnQK7fyIFEeJMqDXrnolbu5--q4ZNK9bf81jz7nwPsl8Lvzdv__ZHlz-XGZZ0SxILqU7e4RoeK95IKJlfx-vZGM_xBEbNaSsj_HNJp_</recordid><startdate>200003</startdate><enddate>200003</enddate><creator>Ouwens, J.P.</creator><creator>Haaxma-Reiche, H.</creator><creator>Verschuuren, E.A.M.</creator><creator>Timens, W.</creator><creator>Steenhuis, L.H.</creator><creator>De Boer, W.J.</creator><creator>Van Der Bij, W.</creator><general>Munksgaard International Publishers</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200003</creationdate><title>Visual symptoms after lung transplantation: a case of progressive multifocal leukoencephalopathy</title><author>Ouwens, J.P. ; 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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adult Autopsy Brain - pathology cataract Cerebellum - pathology Fatal Outcome Humans JC virus JC Virus - isolation & purification Leukoencephalopathy, Progressive Multifocal - cerebrospinal fluid Leukoencephalopathy, Progressive Multifocal - diagnosis Lung Transplantation Magnetic Resonance Imaging Male Postoperative Complications progressive multifocal leukoencephalopathy Vision Disorders - etiology Visual Acuity |
| title | Visual symptoms after lung transplantation: a case of progressive multifocal leukoencephalopathy |
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