Abstract：
Progressive multifocal leukoencephalopathy (PML), a severe demyelinating disease of the central nervous system, is caused by the reactivation of the polyomavirus JC virus (JCV). It favors the cerebrum and typically occurs in patients with immunodeficiencies, with a progressive course and fatal outcome in the majority of cases. However, the cerebellar form of PML, characterized by isolated posterior fossa lesions, such as those in the cerebellum or brainstem at disease onset, is rare, and reports of its occurrence in peritoneal dialysis (PD) patients are lacking. In this paper, we describe a rare case of a cerebellar form of PML in a PD patient. A 64-year-old man undergoing PD was referred to our hospital for anorexia, nausea, and vomiting in the past month. He had finger-to-nose test abnormalities, gaze-directed nystagmus, and scanning speech. He was diagnosed with the cerebellar form of PML based on his progressive cerebellar symptoms, the typical magnetic resonance imaging findings, and the presence of JCV-DNA in the cerebrospinal fluid polymerase chain reaction test. He developed nocturnal delirium, aggravated disquiet, and died of pneumonia on the 69th day. Clinicians should consider the cerebellar form of PML as a differential diagnosis if PD patients develop progressive cerebellar symptoms.
摘要：
进行性多灶性白质脑病（PML），严重的中枢神经系统脱髓鞘疾病，是由多瘤病毒JC病毒（JCV）的再激活引起的。它有利于大脑，通常发生在免疫缺陷患者中，在大多数情况下，进展过程和致命的结果。然而,PML的小脑形式，以孤立的后窝病变为特征，例如疾病发作时小脑或脑干中的那些，是罕见的，缺乏在腹膜透析（PD）患者中发生的报道。在本文中,我们描述了一例罕见的PD患者的小脑型PML病例.一名接受PD的64岁男子因厌食症被转诊到我们医院，恶心,在过去的一个月里呕吐。他有指鼻检查异常,凝视导向的眼球震颤,扫描语音。根据他的进行性小脑症状，他被诊断为小脑型PML，典型的磁共振成像发现，以及脑脊液聚合酶链反应试验中JCV-DNA的存在。他出现了夜间谵妄,加剧的不安，在第69天死于肺炎.如果PD患者出现进行性小脑症状，临床医生应考虑PML的小脑形式作为鉴别诊断。
