Relapsing and remitting human immunodeficiency virus-associated leukoencephalomyelopathy.
We describe a 33-year-old homosexual man with a steroid-responsive, remitting and relapsing leukoencephalopathy associated with recent human immunodeficiency virus type 1 (HIV-1) seroconversion. Biopsy of a parieto-occipital lesion revealed demyelination and astrogliosis with focal necrosis. Detailed investigations demonstrated no pathogens in the brain other than HIV-1. This patient illustrates that a neurological disorder clinically indistinguishable from multiple sclerosis may be the presenting manifestation of HIV-1 infection and may occur in the absence of clinically significant immunosuppression.
Berger
J R
JR
Department of Neurology, University of Miami School of Medicine, FL 33151.
Tornatore
C
C
Major
E O
EO
Bruce
J
J
Shapshak
P
P
Yoshioka
M
M
Houff
S
S
Sheremata
W
W
Horton
G F
GF
Landy
H
H
D015526:AIDS Dementia Complex / Q000175:diagnosis; D000328:Adult; D001853:Bone Marrow / Q000382:microbiology; D001921:Brain / Q000382:microbiology / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1 / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis; D012008:Recurrence