JC virus granule cell neuronopathy in the setting of chronic lymphopenia treated with recombinant interleukin-7

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Abstract

JC virus (JCV) is a human polyomavirus that infects the central nervous system (CNS) of immunocompromised patients. JCV granule cell neuronopathy (JCV-GCN) is caused by infection of cerebellar granule cells, causing ataxia. A 77-year-old man with iatrogenic lymphopenia presented with severe ataxia and was diagnosed with JCV-GCN. His ataxia and CSF improved with intravenous immunoglobulin, high-dose intravenous methylprednisolone, mirtazapine, and mefloquine. IL-7 therapy reconstituted his lymphocytes and reduced his CSF JCV load. One month after IL-7 therapy, he developed worsening ataxia and CSF inflammation, which raised suspicion for immune reconstitution inflammatory syndrome. Steroids were restarted and his ataxia stabilized.

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Author and article information

Journal

Journal ID (nlm-journal-id): 9508123

Journal ID (pubmed-jr-id): 20381

Journal ID (nlm-ta): J Neurovirol

Journal ID (iso-abbrev): J. Neurovirol.

Title: Journal of neurovirology

ISSN (Print): 1355-0284

ISSN (Electronic): 1538-2443

Publication date Nihms-submitted: 27 July 2017

Publication date (Electronic): 15 July 2016

Publication date (Print): February 2017

Publication date PMC-release: 01 February 2018

Volume: 23

Issue: 1

Pages: 141-146

Affiliations

[1 ]Department of Neurology, Washington University, St. Louis, MO, USA

[2 ]Department of Pathology and Immunology, Washington University, St. Louis, MO, USA

[3 ]Department of Infectious Diseases, Washington University, St. Louis, MO, USA

[4 ]Laboratory of Molecular Medicine and Neuroscience, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA

[5 ]Department of Neurology, Division of Neuro-Immunology and Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Boston, MA, USA

Author notes

[* ]Corresponding author: Robert Bucelli, MD, Department of Neurology. Washington University School of Medicine. Campus Box 8111. 660 South Euclid Ave., St. Louis, MO 63110, bucellir@ 123456neuro.wustl.edu , Telephone: 314-362-6981, Fax: 314-362-0338

Article

Accession ID: PMC5588866 Pmcid ID: PMC5588866 Pmc-uid ID: 5588866 Manuscript ID: nihpa890782

DOI: 10.1007/s13365-016-0465-0

PMC ID: 5588866

PubMed ID: 27421731

SO-VID: 68ec00ab-2930-4895-8927-3d72c0f066f6

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