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Peer-reviewedCC BY-NC-ND 4.0BMC Neurology

A case of progressive multifocal leukoencephalopathy in a cirrhotic patient

  • Chenrui Song1
  • Yanqun Liu2
  • Xiaoying Bi2
  • Shi Wang1
  1. 1Department of Neurology, The Third Affiliated Hospital of Naval Military Medical University, Shanghai, China
  2. 2Department of Neurology, The First Affiliated Hospital of Naval Military Medical University, Shanghai, China
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Abstract

Background: Progressive multifocal leukoencephalopathy (PML) is a rare fatal central nervous system demyelinating disease caused by John Cunningham virus (JCV). Immunodeficiency induces JCV reactivation, resulting in oligodendrocyte lysis, demyelination, and astrocytic dysfunction.

Case presentation: We reported a 54-year-old male presenting with mild motor aphasia and cognitive decline. He was initially misdiagnosed with cirrhotic hepatic encephalopathy, with no response to ammonia-lowering treatment. Routine cerebrospinal fluid tests were unremarkable, while Matagenomics Capture (MetaCAP), a high-throughput sequencing technology identified 226 JCV sequences, confirming PML.

Conclusion: PML has heterogeneous manifestations and is easily underdiagnosed in cirrhotic patients. Early differential diagnosis, CSF JCV detection, or brain biopsy is essential.

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Cite

BibTeXRIS
BibTeX
@article{song2026case,
  title = {{A case of progressive multifocal leukoencephalopathy in a cirrhotic patient}},
  author = {Chenrui Song and Yanqun Liu and Xiaoying Bi and Shi Wang},
  journal = {BMC Neurology},
  year = {2026},
  month = jul,
  doi = {10.1186/s12883-026-05154-3},
  url = {https://doi.org/10.1186/s12883-026-05154-3},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - A case of progressive multifocal leukoencephalopathy in a cirrhotic patient
AU  - Chenrui Song
AU  - Yanqun Liu
AU  - Xiaoying Bi
AU  - Shi Wang
PY  - 2026
DA  - 2026/07/31
JO  - BMC Neurology
DO  - 10.1186/s12883-026-05154-3
UR  - https://doi.org/10.1186/s12883-026-05154-3
AB  - Background: Progressive multifocal leukoencephalopathy (PML) is a rare fatal central nervous system demyelinating disease caused by John Cunningham virus (JCV). Immunodeficiency induces JCV reactivation, resulting in oligodendrocyte lysis, demyelination, and astrocytic dysfunction.  Case presentation: We reported a 54-year-old male presenting with mild motor aphasia and cognitive decline. He was initially misdiagnosed with cirrhotic hepatic encephalopathy, with no response to ammonia-lowering treatment. Routine cerebrospinal fluid tests were unremarkable, while Matagenomics Capture (MetaCAP), a high-throughput sequencing technology identified 226 JCV sequences, confirming PML.  Conclusion: PML has heterogeneous manifestations and is easily underdiagnosed in cirrhotic patients. Early differential diagnosis, CSF JCV detection, or brain biopsy is essential.
SN  - 1471-2377
ER  -