A 26-year-old female with known multiple sclerosis on interferon-beta therapy presents with progressive cognitive decline, visual disturbances, and ataxia over 4 weeks. Vital signs: BP 118/76, HR 82, RR 16, Temp 37.2°C, SpO2 98%. Brain MRI reveals new multifocal white matter lesions without contrast enhancement. CSF analysis shows JC virus PCR positive; oligoclonal bands negative. Which of the following is the most likely diagnosis?
- A)Subacute combined degeneration
- B)Interferon-beta-induced demyelination
- C)Progressive multifocal leukoencephalopathyGABARITO
- D)Methotrexate-induced leukoencephalopathy
- E)MS disease progression
Explicação
PML is caused by JC polyomavirus and typically occurs in severely immunocompromised patients. The positive CSF JC virus PCR is diagnostic. PML presents with progressive multifocal neurologic deficits, non-enhancing white matter lesions, and is often fatal with... Ver explicação completa e trilha adaptativa →