Progressive multifocal leukoencephalopathy in an elderly immunocompetent-appearing patient: Relevance with L-selectin (CD62L) expression and immunosenescence

Clin Neurol Neurosurg. 2021 Jun:205:106625. doi: 10.1016/j.clineuro.2021.106625. Epub 2021 Apr 1.

Abstract

Progressive multifocal leukoencephalopathy (PML) is attributed to reactivation of the John Cunningham virus (JCV), in the central nervous system as a result of immunosuppression. Low L-selectin (CD62L) expression on cryopreserved T-cells has been advocated as a biomarker for natalizumab related PML in patients with Relapsing-Remitting Multiple Sclerosis. A rare case of PML in an elderly patient without known factors of immunosuppression or immunomodulation is hereby presented. T-cell L-selectin expression levels and serum anti-JCV antibody index were evaluated in order to explore mechanistic insight to the pathways that presumably contribute towards PML development in this rare clinical setting.

Keywords: Ageing; Immunocompetent; Immunosenescence; L-selectin; Progressive Multifocal Leukoencephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biopsy
  • Brain / diagnostic imaging
  • Brain / pathology
  • Female
  • Humans
  • Immunocompetence
  • Immunosenescence / immunology
  • JC Virus / immunology
  • L-Selectin / biosynthesis*
  • L-Selectin / blood
  • Leukoencephalopathy, Progressive Multifocal / blood
  • Leukoencephalopathy, Progressive Multifocal / diagnosis
  • Leukoencephalopathy, Progressive Multifocal / drug therapy
  • Leukoencephalopathy, Progressive Multifocal / immunology*
  • Magnetic Resonance Imaging
  • T-Lymphocytes / immunology*

Substances

  • Biomarkers
  • L-Selectin