A 45-year-old woman with multiple sclerosis on interferon-beta presents with progressive cognitive decline, gait disturbance, and blurred vision over 2 months. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Brain MRI reveals multifocal white matter lesions with enhancement and mass effect. CSF JC virus PCR is positive; oligoclonal bands are negative. Which of the following is the most likely complication?
- A)Interferon-induced thyroiditis
- B)Secondary progressive MS
- C)Fingolimod-associated macular edema
- D)MS relapse
- E)Progressive multifocal leukoencephalopathyGABARITO
Explicação
Progressive multifocal leukoencephalopathy (PML) is caused by JC virus reactivation and occurs in immunocompromised patients. Positive JC virus PCR in CSF is diagnostic. PML presents with subacute progressive neurological decline including cognitive, motor, an... Ver explicação completa e trilha adaptativa →