Systemic Lupus Erythematosus, Progressive Multifocal Leukoencephalopathy, and T-CD4+ Lymphopenia
Clinical Reviews in Allergy and Immunology, 06/29/2012
Brandao M et al. – The authors present two patients with the diagnosis of systemic lupus erythematosus (SLE) and progressive multifocal leukoencephalopathy (PML): One had a heavy immunosuppressive therapy history, and the other had never experienced biologic or cytotoxic therapeutics. Both patients had a profound T–CD4+ lymphopenia during their clinical history. These two cases emphasize the importance of CD4+ lymphopenia in SLE patients with and without immunosuppressors regarding opportunistic infections.
- Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection caused by the reactivation of JC virus and occurs in patients with severe primary or secondary immunosuppression.
- Recently, PML is becoming relevant in autoimmune disorders, particularly in patients treated with biologic agents.
- However, systemic lupus erythematosus (SLE) appears to be associated with susceptibility to PML that cannot be entirely explained by the immunosuppressive therapy.