[Progressive multifocal leukoencephalopathy in acquired immunodeficiency syndrome].
Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection in HIV-infected persons. We present the characteristics of seven cases of PML, which represent 3.1% of our patients with AIDS. In six cases, was the "marker" disease for AIDS. The most common clinical manifestation was a slowly evolving focal neurological syndrome (average time of pre-hospitalization symptoms was 64 days). The number of T4 lymphocytes at the moment of diagnosis varied between 14 and 121 cel/mm3 (median: 51). Computerized tomography (CT) and cranial nuclear magnetic resonance (NMR) showed images of single (4 cases) or multiple white substance involvement without contrast uptake or mass-effect. The definitive diagnosis was made by cerebral biopsy. Four died within 20 to 90 days of diagnosis. Three of the five who received antiretrovirals survived with apparent stabilization of the process at 2, 13, and 23 months of diagnosis. PML can be an initial diagnostic disease for AIDS. Its symptoms and the CT/NMR should arouse suspicion. However, given that clinicoradiological data are often insufficient, it is advisable to conduct cerebral biopsies. Antiretrovirals may have a favorable effect on diseases course.
Clavo Sánchez
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A
Unidad de Enfermedades Infecciosas, Hospital Universitario Puerta del Mar, Cádiz.
García-Gil
D
D
Sasián Martínez
S
S
Geraldía Lama
M
M
Serrano González
A
A
Bascuñana Quirell
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A
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000150:complications / Q000175:diagnosis*; D008297:Male
Leucoencefalopatía multifocal progresiva en el síndrome de inmunodeficiencia adquirida.