Abstract
Although progressive multifocal leukoencephalopathy (PML) cases showing responses
to mefloquine therapy have been reported, the efficacy of mefloquine for PML remains
unclear. We report on the failure of mefloquine therapy in two Japanese patients with
PML unrelated to human immunodeficiency virus. One of the patients was a 47-year-old
male who had been treated with chemotherapy for Waldenström macroglobulinemia, and
the other was an 81-year-old male with idiopathic CD4+ lymphocytopenia. Diagnosis of PML was established based on MRI findings and increased
JC virus DNA in the cerebrospinal fluid in both patients. Mefloquine was initiated
about 5 months and 2 months after the onset of PML, respectively. During mefloquine therapy, clinical and
radiological progression was observed, and JC virus DNA in the cerebrospinal fluid
was increased in both patients. Both patients died about 4 months and 2 months after initiation of mefloquine, respectively. Further studies are necessary
to clarify the differences between mefloquine responders and non-responders in PML.
Keywords
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Article info
Publication history
Published online: November 26, 2012
Accepted:
November 6,
2012
Received in revised form:
November 3,
2012
Received:
August 24,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
