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Rheumatology 2002; 41: 826-827
© 2002 British Society for Rheumatology

Letters to the Editor

Progressive multifocal leucoencephalopathy isolated to the posterior fossa in a patient with systemic lupus erythematosus

R. P. White, S. Abraham1, S. Singhal, H. Manji and C. R. A. Clarke

National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG and
1 Department of Rheumatology, Whipps Cross Hospital, London E11 1NR, UK

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SIR, Progressive multifocal leucoencephalopathy (PML) may complicate immunosuppressive states other than HIV infection. Its presentation as an isolated posterior fossa lesion is uncommon. We describe here ante-mortem diagnosis on cerebellar biopsy of PML in a patient with systemic lupus erythematosus (SLE) immunosuppressed with prednisolone and azathioprine. The case illustrates both that immunosuppression, other than that induced by HIV, may be complicated by PML and that this devastating opportunistic viral infection should be considered in the differential diagnosis of isolated progressive posterior fossa white matter disease.

A 41-yr-old Asian . . . [Full Text of this Article]


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