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July 1976

Progressive Multifocal Leukoencephalopathy in Renal Transplant Recipients

Author Affiliations

From the Division of Neuropathology, Department of Pathology (Drs McCormick and Schochet), Department of Neurology (Drs McCormick and Calverley), and the Division of Nephrology, Department of Internal Medicine (Dr Sarles), University of Texas Medical Branch, Galveston.

Arch Intern Med. 1976;136(7):829-834. doi:10.1001/archinte.1976.03630070067020

Progressive multifocal leukoencephalopathy (PML), a slowly progressive papovavirus infection of the central nervous system (CNS), has been reported in more than 110 patients to date, over half of whom have had either leukemia or lymphoma.1-13 Only occasionally has no obvious underlying immune-altering disorder been noted.1,2 To our knowledge, only three patients have been reported previously to have developed PML after long-term immunosuppression for renal transplantation5,12,13; the patient discussed here is the fourth. Our patient also demonstrated unilateral parkinsonian signs attributable to involvement of the extrapyramidal motor system. Parkinsonism has been a very unusual clinical manifestation of PML, and has been reported previously in only one patient.14 We believe that PML is emerging as a potentially serious problem in renal transplant recipients.

PATIENT SUMMARY  A 34-year-old man who had had multiple admissions for chronic renal failure and hypertension caused by chronic proliferative glomerulonephritis had both kidneys (and

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