mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2015-3-4-9mrj-631Research ArticleЛЕКЦИИLECTURESПрогрессирующая мультифокальная лейкоэнцефалопатия: ревматологические аспектыProgressive multifocal leukoencephalopathy: rheumatological aspectsБеловБорис СергеевичBelovBoris Sergeevich

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

belovbor@yandex.ruФГБНУ Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation2015180920159349Copyright © Белов Б.С., 20152015Белов Б.С.Belov B.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/631

Прогрессирующая мультифокальная лейкоэнцефалопатия (ПМЛ) – тяжелое прогрессирующее заболевание вирусной этиологии, протекающее с поражением ЦНС у больных с иммунодефицитом. Оно может развиваться как осложнение у больных с системными воспалительными ревматическими заболеваниями (в первую очередь с системной красной волчанкой), в том числе при проведении активной противоревматической терапии. В статье изложены данные об эпидемиологии, этиологии и патогенезе заболевания, охарактеризована клиническая картина, освещены основные подходы к диагностике, приведены современные диагностические критерии. Представлен опросник, применяемый с целью мониторинга неврологического статуса. Подчеркивается важность такого мониторинга, так как ранняя диагностика и своевременное прекращение лечения препаратом – потенциальным «триггером» ПМЛ – являются факторами, в наибольшей степени определяющими прогноз.

Progressive multifocal leukoencephalopathy (PML) is a severe progressive viral disease that affects the central nervous system in patients with immunodeficiency. It may develop as a complication in patients with systemic inflammatory rheumatic diseases (primarily in those with systemic lupus erythematosus), including that during active antirheumatic therapy. The paper presents data on the etiology, epidemiology, and pathogenesis of the disease, characterizes its clinical presentation, highlights main approaches to its diagnosis, and gives current diagnostic criteria. A questionnaire used to monitor neurological status is shown. The paper emphasizes the importance of this monitoring, for early diagnosis and timely cessation of PML treatment with a drug, a potential trigger, are factors that influence prognosis to the utmost degree.

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The authors declare that there are no conflicts of interest present.