School of Medicine

Wayne State University School of Medicine

Progressive Multifocal Leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a disease of the white matter of the brain, caused by a virus infection that targets cells that make myelin--the material that insulates nerve cells (neurons).  Polyomavirus JC (often called JC virus) is carried by a majority of people and is harmless except among those with lowered immune defenses.  The disease is rare and occurs in patients undergoing chronic corticosteroid or immunosuppressive therapy for organ transplant, or individuals with cancer (such as Hodgkin’s disease or lymphoma).  Individuals with autoimmune conditions such as multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosis, some of whom are treated with biological therapies that allow JC virus reactivation, are at risk for PML as well.  PML is most common among individuals with HIV-1 infection/acquired immune deficiency syndrome (AIDS).  Studies estimate that prior to effective antiretroviral therapy, as many as 5 percent of persons infected with HIV-1 eventually develop PML that is an AIDS-defining illness.

Our Laboratory Investigates:

Quantification of tissue injury that distinguishes between MS activity from that of PML is done by using certain MRI characteristics. Magnetization transfer ratio (MTR) studies may provide additional clues in improving early detection of PML in patients with pre-existing MS and warrant further investigation.

T2-W image showing Lesion in ROI (region of interest in Red)
T1-W image showing Lesion in ROI (region of interest in Red)
T1-W Post contrast image showing GAD enhancing Lesion in ROI (region of interest in Red)
Axial FLAIR image used as reference for estimating Lesion volume