TY - JOUR
T1 - JC virus granule cell neuronopathy in the setting of chronic lymphopenia treated with recombinant interleukin-7
AU - Soleimani-Meigooni, David N.
AU - Schwetye, Katherine E.
AU - Angeles, Maria Reyes
AU - Ryschkewitsch, Caroline F.
AU - Major, Eugene O.
AU - Dang, Xin
AU - Koralnik, Igor J.
AU - Schmidt, Robert E.
AU - Clifford, David B.
AU - Kuhlmann, F. Matthew
AU - Bucelli, Robert C.
N1 - Funding Information:
Dr. Koralnik was funded in part by NIH grants R01 NS047029 and R01 NS074995.
Publisher Copyright:
© 2016, Journal of NeuroVirology, Inc.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - 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 cerebrospinal fluid (CSF) improved with intravenous immunoglobulin, high-dose intravenous methylprednisolone, mirtazapine, and mefloquine. Interleukin-7 (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.
AB - 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 cerebrospinal fluid (CSF) improved with intravenous immunoglobulin, high-dose intravenous methylprednisolone, mirtazapine, and mefloquine. Interleukin-7 (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.
KW - Cerebellar ataxia
KW - Granule cell neuronopathy
KW - Il-7
KW - JC virus
KW - Lymphopenia
UR - http://www.scopus.com/inward/record.url?scp=84978823355&partnerID=8YFLogxK
U2 - 10.1007/s13365-016-0465-0
DO - 10.1007/s13365-016-0465-0
M3 - Article
C2 - 27421731
AN - SCOPUS:84978823355
SN - 1355-0284
VL - 23
SP - 141
EP - 146
JO - Journal of NeuroVirology
JF - Journal of NeuroVirology
IS - 1
ER -