PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY RESEMBLING CENTRAL-NERVOUS-SYSTEM SYSTEMIC LUPUS-ERYTHEMATOSUS

A 21-year-old woman with a 6-year history of SLE presented with a spee ch disturbance and right hand clumsiness along with manifestations of active disease suggesting central nervous system SLE. Despite aggressi ve treatment for SLE, her neurological condition worsened. MRI demonst rated low intensity in T1-weighted images and high intensity in T2-wei ghted images in the white matter of the bilateral cerebrum and cerebel lum, compatible with progressive multifocal leukoencephalopathy (PML). Intraspinal administration of interferon-beta seemed to slow the dete rioration of her MRI and neurological findings. However she eventually developed decerebrate rigidity and died due to candidemia. DNA of the JC vius was detected in the autopsied brain by the polymerase chain r eaction technique. PML should always be borne in mind when examining p atients with SLE showing neurological abnormalities.