進行性多巣性白質脳症（PML）診療ガイドライン2017

1 - i - i N?GHJ s t progressive multifocal leukoencephalopathy: PML 2017 t PML s3 t s s s1 s s tPML s t PMLtJC s s s s t s s t HIV s t PML s s PMLs t PML [ ]

2 SPML PMLs s t PMLs sPML s s PMLs t t PML 2013 t PMLs s t sPMLs PMLs s PMLs s PMLs s s t JC DNA PML s t s s s t s s s s s s t s s s s t t t s 2017 3 - ii - ii jp[t Q YXqa N ET n n n n 4 q 5 IJ nj n n n n n n n n n n n -d n MRI nj n n n n n n n n 4 SSPE 5 n n n n n n n n n n NJ lj n n nj n n n n DZ n n n n 6 28 12 n 29 1 6 d n]

3 4 PML 5 on } nj - nj n n n n n d 4 PML 5 nj n n n n n n z n n n n n n n n on } NJ n - iii - iii \XeoXt w on } nj - nj n n n n z n n n n 4 5 on } n z nj ii jp[t Q YXqa N ET n n n n 4 q 5 IJ nj n n n n n n n n n n n -d n MRI nj n n n n n n n n 4 SSPE 5 n n n n n n n n n n NJ lj n n nj n n n n DZ n n n n 6 28 12 n 29 1 6 d n 4 PML 5]

4 On } nj - nj n n n n n d 4 PML 5 nj n n n n n n z n n n n n n n n on } NJ n i ii 876 iii 1 876 4 4 7 10 876 12 7 12 14 16 20 22 876 25 876

5 29 876 876 29 32 876 876 876 35 39 43 876 45 46 D . 48 - 1 - & Lj progressive multifocal leukoencephalopathy: PML 2 5 2 5 human immunodeficiency virus: HIV 2 } R DZ PML S q S 2 C " PML K S DZ' JC JC virus: JCV PML O l PML S D $ L PML !

6 \ DZ L PML= L rh ( [ 7 26 PML= 26 9 6 PML 2013 PML 2017 26 l 27 1 20 PML 2017 Z g = j PML 2017 PML = K r s IJ 7 876 876 7 876 876 876 876 876 876 876 - 2 - 876 !)]

7 Z Z ? ! L Q Z L 5r Z Dz ! L Q Z Z % ! L Q * Z L 5r Z Dz ; ( ! L Q ; Z Z % ) ! L Q * Z L 5r K ! : \ 6 ( Medline 2015 3 31 ( Minds Ver. 1 " d d Nj nj d d Nj nj ~ d d Nj nj d d i LJ * 4 i" 4 i" } ~ 4 i" m i DZ~ 4 i" - 3 - & d m d dLJ Y m d ~ dLJ~ Y m d ~ dLJ DZ~ Y m d dLJ } Y \XeoXt yO LFO O u O @NI@J ( j ( f ASQ O NI@J LJ L Y N/ d L = B ] DZ _ l B ] !))))

8 + ( ) Minds rn n l . ( ) lj EBM ij . 2014.' 876 !Z Z ? ! L Q Z L 5r Z Dz ! L Q Z Z % ! L Q * Z L 5r Z Dz ; ( ! L Q ; Z Z % ) ! L Q * Z L 5r K ! : \ 6 ( Medline 2015 3 31 ( Minds Ver. 1 " d d Nj nj d d Nj nj ~ d d Nj nj d d i LJ * 4 i" 4 i" } ~ 4 i" m i DZ~ 4 i" - 4 - R 876 !))

9 `s LJ dz Lj ` s ^ G L LJ } l ` Lj ! ( LJY ( * ^ LJ 7 M dz Lj ! } < m Lj ! z ! l l Dzb ` LJ LJ s f Dz h n i Lj ! ij LJ ( Q Lj ! 6 G LJ( - ! K Lj ! dz 2 F LJ dz L dz P dz DZ Lj P PML = DNA JCV 1-3 JCV PML JCV JCV JCV 1 PML JCV lj Lj PML 2 PML ?))))

10 L 4 2 5 , AIDS HIV <l AIDS p PML 85% HIV 5 2 u 2 CG " PML K 6 S q PML R ; dz " PML W y 0 7-11 DZ PML