A 28-year-old man with multiple sclerosis on interferon-beta therapy for 3 years presents with progressive encephalopathy, confusion, and ataxia over 2 months. Vital signs: BP 128/82, HR 92, RR 18, Temp 37.2°C, SpO2 98%. Brain MRI reveals multiple asymmetric white matter lesions without enhancement. Serum JC virus PCR is positive. CSF analysis shows no pleocytosis. Which of the following is the most likely complication?
- A)Interferon-induced autoimmune encephalitis
- B)Infectious myelitis
- C)MS disease progression
- D)Secondary progressive MS with dementia
- E)Progressive multifocal leukoencephalopathyGABARITO
Explicação
PML is a devastating complication of immunosuppression caused by JC virus reactivation. The positive serum JC virus PCR combined with progressive neurological decline and white matter lesions in an immunosuppressed MS patient on interferon-beta is pathognomoni... Ver explicação completa e trilha adaptativa →