Dual Therapy with Cidofovir and Mirtazapine for Progressive Multifocal Leukoencephalopathy in a Sarcoidosis Patient

• Main Authors: Jae Hyun Park, Sookyung Ryoo, Hyun Jin Noh, Jung Min Seo, Hyun Hee Kang, Ji Soo Shin, Sang Won Seo, Duk L. Na
• Format: Article
• Language: English
• Published: Karger Publishers 2011-10-01
• Series: Case Reports in Neurology
• Subjects: Progressive multifocal leukoencephalopathy; Sarcoidosis; Cidofovir; Mirtazapine
• Online Access: http://www.karger.com/Article/FullText/333780
• ISSN: 1662-680X

Background: Progressive multifocal leukoencephalopathy (PML) is a demyelinating central nervous system disease caused by JC virus (JCV) reactivation in immunocompromised patients. The disease course of PML is often progressive, fatal and at present, there are few reports on successful treatment outcomes. Case Report: A 45-year-old man with systemic sarcoidosis presented with rapidly progressive dementia and right hemiparesis. The patient was diagnosed with PML as confirmed via brain biopsy and JCV PCR. With a combination treatment of cidofovir and mirtazapine, there was significant improvement of neurological symptoms without measurable functional deficit. Conclusion: This case suggests that dual therapy with cidofovir and mirtazapine might be an effective treatment option in PML patients with sarcoidosis.