Fulminant JC virus encephalopathy with productive infection of cortical pyramidal neurons

Christian Wüthrich, Xin Dang, Susan Westmoreland, John McKay, Atul Maheshwari, Matthew P. Anderson, Allan H. Ropper, Raphael P. Viscidi, Igor J. Koralnik

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


The polyomavirus JC (JCV) is the causative agent of progressive multifocal leukoencephalopathy and of JCV granule cell neuronopathy. We present a human immunodeficiency virus-negative patient who experienced development of multiple cortical lesions, aphasia, and progressive cognitive decline after chemotherapy for non-small-cell lung cancer. Brain biopsy and cerebrospinal fluid polymerase chain reaction demonstrated JCV, and she had a rapidly fatal outcome. Postmortem analysis showed diffuse cortical lesions and areas of necrosis at the gray-white junction. Immunostaining showed a productive JCV infection of cortical pyramidal neurons, confirmed by electron microscopy, with limited demyelination. This novel gray matter syndrome expands the scope of JCV clinical presentation and pathogenesis.

Original languageEnglish (US)
Pages (from-to)742-748
Number of pages7
JournalAnnals of neurology
Issue number6
StatePublished - Jun 2009

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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