A pathologically distinct new form of HIV associated encephalopathy.
We present the clinical, morphological and neuropathological findings in a 44-year-old male suffering from the acquired immunodeficiency syndrome (AIDS) (CDC stage IV C2) who presented with rapidly progressive right-side hemiparesis and developed hemianopia and aphasia. Scans showed multiple, not contrast-enhancing, not space-occupying echo-intensive lesions in T2-weighted MR-imaging. No hint for an opportunistic infection, necrotizing vasculitis or vascular disease was found. All therapeutic regimens failed and 8 weeks after onset of neurological symptoms the patient died because of cardiorespiratory arrest. Post-mortem examination excluded opportunistic infection, progressive multifocal leukoencephalopathy, lymphoma, vasculitis and ischemia of the brain. In the presence of an unusually high amount of HIV-infected macrophages at immunohistochemical examination, the overall pathological findings were atypical both for HIV encephalitis and HIV leukoencephalopathy. We describe a pathologically distinct new form of HIV associated encephalopathy.
von Giesen
H J
HJ
Department of Neurology, Heinrich-Heine-University Dusseldorf, Germany.
Arendt
G
G
Neuen-Jacob
E
E
Prestien
K
K
Jablonowski
H
H
Freund
H J
HJ
D015526:AIDS Dementia Complex / Q000473:pathology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000473:pathology; D000328:Adult; D001921:Brain / Q000473:pathology; D006429:Hemiplegia / Q000503:physiopathology; D006801:Humans; D007124:Immunoenzyme Techniques; D008279:Magnetic Resonance Imaging; D008297:Male; D016612:Paraffin Embedding