sirolimus and Hallucinations

Progressive multifocal leukoencephalopathy is a rare, highly fatal demyelinating brain infection caused by the JC virus. This infection is associated with immunosuppressive agents and is emerging in the transplant population. There has never been a documented case of progressive multifocal leukoencephalopathy in a transplant recipient receiving sirolimus. We present a study, in which the JC virus was found in a 68-year-old man who had received a postorthotopic heart transplant 3 years earlier and who was receiving sirolimus and prednisone for immunosuppression. We review the clinical presentation, diagnosis, current treatment options, and the outcomes of progressive multifocal leukoencephalopathy in transplant recipients.

Topics: Aged; Biopsy; Confusion; Early Diagnosis; Electroencephalography; Fatal Outcome; Hallucinations; Heart Transplantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Leukoencephalopathy, Progressive Multifocal; Magnetic Resonance Imaging; Male; Polymerase Chain Reaction; Prednisone; Rare Diseases; Sirolimus; Spinal Puncture