Progressive multifocal leukoencephalopathy as the first manifestation of occult sarcoidosis: case report and review of the literature

摘要

A patient presented with mental status changes over several weeks. Imaging indicated several areas of hyperintensity in the white matter of the temporal and parieto-occipital lobes. Brain biopsy and CSF analysis led to the diagnosis of progressive multifocal leukoencephalopathy (PML). Though this patient had no clinical evidence of immune suppression, autopsy later indicated the presence of undiagnosed systemic sarcoidosis, which has been associated with PML.