Shankari Ravichandran
Columbia University Medical Center, USA
Title: Expressive Aphasia in Lung Transplant Recipient
Biography
Biography: Shankari Ravichandran
Abstract
Progressive multifocal leukoencephalopathy (PML) is associated with John Cunningham polyomavirus (JCV) infection of central nervous system oligodendrocytes, resulting in demyelination and progressive focal neurologic deficits. In the setting of immunosuppression, reactivation of dormant JCV has been noted in patients with Human Immunodeficiency Virus (HIV) (Fong & Toma, 1995). I would like to present a case history of a post single lung transplant recipient, 66-years of age, female, cytomegalovirus seropositive, Epstein-Barr virus(EBV) seropositive, Chronic Obstructive Pulmonary Disease (COPD) patient, who presented with symptoms of aphasia associated with word-finding difficulties and swaying to one side when walking lasting one week, which progressively worsened. A diagnosis of PML was established via brain biopsy and correlating brain images. This case outlines the difficulty of balancing immunosuppression for post lung transplant patient, in the setting of an established diagnosis of PML. The patient died as PML symptoms progressed in the setting of decreased immunosuppression from respiratory failure secondary to acute rejection