論文

査読有り 筆頭著者 国際誌
2012年10月15日

Characteristics of progressive multifocal leukoencephalopathy clarified through internet-assisted laboratory surveillance in Japan.

BMC Neurology
  • Kazuo Nakamichi
  • ,
  • Hidehiro Mizusawa
  • ,
  • Masahito Yamada
  • ,
  • Shuji Kishida
  • ,
  • Yoshiharu Miura
  • ,
  • Toshio Shimokawa
  • ,
  • Tomohiko Takasaki
  • ,
  • Chang-Kweng Lim
  • ,
  • Ichiro Kurane
  • ,
  • Masayuki Saijo

12
開始ページ
121
終了ページ
121
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/1471-2377-12-121

BACKGROUND: Progressive multifocal leukoencephalopathy (PML), a rare but fatal demyelinating disease caused by JC virus (JCV), occurs mainly in immunocompromised patients. As PML develops in individuals with various underlying disorders sporadically and infrequently, a nationwide survey of PML is difficult. This study was conducted to elucidate the characteristics of PML in Japan through an internet-assisted laboratory surveillance program. METHODS: A diagnostic support system for PML was established using a real-time PCR assay of JCV DNA in cerebrospinal fluid (CSF), and requests for testing were received from clinicians via specialized websites. Medical histories of patients were collected through standardized questionnaires, and a database of CSF JCV loads and clinical information was created and analyzed. RESULTS: For 4 years from April 2007 to March 2011, CSF specimens from 419 patients were tested. Forty-eight individuals were found positive for JCV DNA in their CSF and were diagnosed with PML. PML primarily occurred not only in HIV-positive patients (33.3%) but also in patients with hematologic disorders after receiving stem cell transplantation, chemotherapy, and/or immunosuppressive treatment (39.6%). The frequencies of PML cases among the subjects in these two categories were 20.3% and 23.5%, respectively. Although no significant features were observed with respect to CSF JCV loads in PML patients with an HIV infection or hematologic disorder, males were predominant in both groups (100% and 89.5%, respectively). The proportion of PML cases with autoimmune disorders (6.3%) or solid-organ transplants (2.1%) was smaller than those with HIV infection or hematologic disorders, probably due to the limited availability of therapeutic monoclonal antibodies and transplantation from brain dead donors. CONCLUSIONS: The results suggest that the internet-assisted laboratory surveillance program might be a useful strategy for collecting precise real-time information on PML on a national level. The current database provides important background information for the diagnosis and treatment of patients with risk factors for PML.

リンク情報
DOI
https://doi.org/10.1186/1471-2377-12-121
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/23066763
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495800
ID情報
  • DOI : 10.1186/1471-2377-12-121
  • PubMed ID : 23066763
  • PubMed Central 記事ID : PMC3495800

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