A 31-year-old woman with multiple sclerosis on interferon-beta therapy presents with progressive confusion, cognitive decline, and behavioral changes over 4 weeks. Vital signs: BP 118/76, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Brain MRI reveals new periventricular white matter lesions. CSF analysis shows JC virus PCR positive; oligoclonal bands negative. She denies fever, headache, or neck stiffness. Which diagnosis best explains these findings?
- A)Secondary progressive MS
- B)Progressive multifocal leukoencephalopathyGABARITO
- C)Natalizumab-associated IRIS
- D)Autoimmune encephalitis
- E)Mitochondrial encephalomyelopathy
Explicação
Progressive multifocal leukoencephalopathy (PML) is caused by reactivation of JC virus in immunocompromised patients. Positive CSF JC virus PCR is pathognomonic. Though this patient is on interferon-beta (relatively weak immunosuppression), any MS immunotherap... Ver explicação completa e trilha adaptativa →