A forty-one years old female with Progressive multifocal leukoencephalopathy after liver transplant

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused with reactivation of JC virus. Its incidence is very rare after solid organ transplantation especially liver transplantation. We have reported a patient who has received liver transplantation due to liver failure resulting from autoimmune hepatitis and advanced PML presenting with aphasia.A forty-one years old female who has received liver transplantation and has been under treatment of usual regimen of immunosuppression was admitted two month after liver transplantation, with a stroke attack resulting in right hemiplegia. She surprisingly gradually showed dysarthria and left central facial paresis. Brain MRI showed abnormal multifocal high T2/flair signal area in deep and subcortical white matter of left involvement and in splenium of corpus callosum area seen. PCR evaluation for the JCV in CSF showed positive result and the other ordered PCR results were negative.Liver transplant recipient who has been under immunosuppressive treatment for a long time could be affected with PML resulting from reactivation of JCV. Until the time of reporting this case only 8 cases of JCV infections have been reported after liver transplantation. Unfortunately, there is no definite treatment for PML

Keywords:

liver transplant , Progressive multifocal leukoencephalopathy , JC virus