Imaging Insights Into JC Virus-Associated Progressive Multifocal Leukoencephalopathy in Neuropsychiatric Lupus: A Case Report

This case report discusses a 40-year-old female with systemic lupus erythematosus (SLE) and lupus nephritis who developed progressive multifocal leukoencephalopathy (PML) after treatment with rituximab. Initially presenting with right hemiparesis, her condition worsened despite various treatments, leading to cognitive dysfunction and quadriparesis. MRI and cerebrospinal fluid analysis confirmed JC virus-related PML. The report highlights the challenge of distinguishing between neuropsychiatric lupus and rituximab-associated PML, emphasizing the importance of careful monitoring and balancing treatment strategies to minimize the risk of JC virus reactivation in immunocompromised patients.