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RT Journal Article
SR Electronic
T1 JC Virus Infection of the Brain
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1564
OP 1576
DO 10.3174/ajnr.A2035
VO 31
IS 9
A1 Bag, A.K.
A1 Curé, J.K.
A1 Chapman, P.R.
A1 Roberson, G.H.
A1 Shah, R.
YR 2010
UL http://www.ajnr.org/content/31/9/1564.abstract
AB SUMMARY: Since its initial description, there have been significant changes in the epidemiology, pathogenesis, and clinical and imaging manifestations of JCV infection of brain. The most common clinical manifestation is PML. Other recently described CNS manifestations are JCE, JCVGCN, and JCM. Although AIDS is the most common predisposing factor for JCV reactivation, there is increasing incidence of brain manifestations of JCV reactivation in non-HIV settings, including different rheumatologic, hematologic, and oncologic conditions; monoclonal antibody therapy; transplant recipients; primary immunodeficiency syndromes; and even in patients without any recognizable immune deficiency. IRIS may develop secondary to restoration of immunity in HIV-positive patients with PML receiving antiretroviral therapy. This is of profound clinical significance and needs to be diagnosed promptly. Imaging plays a crucial role in the diagnosis of the disease, monitoring of treatment response, identifying disease progression, and predicting prognosis. In this article, current understanding of the epidemiology, pathogenesis, clinical presentations, and all aspects of imaging of JCV infection of the brain have been comprehensively reviewed. ADCapparent diffusion coefficientCNScentral nervous systemcPMLclassic PMLCrcreatineCTLcytotoxic T-lymphocytesDWIdiffusion-weighted imagingFLAIRfluid-attenuated inversion recoveryHAARThighly active antiretroviral therapyHIVhuman immunodeficiency virusICLidiopathic CD4 lymphocytopeniaiPMLinflammatory PMLIRISimmune reconstitution inflammatory syndromeJCEJCV encephalopathyJCMJCV meningitisJCVJC virusJCVGCNJCV granular cell neuronopathymAbmonoclonal antibodymInsmyo-inositolMSmultiple sclerosisMTRmagnetization transfer ratioNAAN-acetylaspartateNIRISneuro-IRISPCRpolymerase chain reactionPMLprogressive multifocal leukoencephalopathyPML-IRISPML associated with IRISRRregulatory regionSLEsystemic lupus erythematosus