title: Neurological reactions in HIV-infected patients treated with trichosanthin.
abstract: Trichosanthin is a ribosome-inactivating protein that is being studied as a possible treatment for patients infected with human immunodeficiency virus (HIV). We report the clinical and pathological features in two patients who experienced neurological reactions to trichosanthin. Both patients were neurologically asymptomatic prior to treatment but developed coma and multifocal neurological deficits after treatment. Neuropathological examination revealed regions of severe, multifocal necrosis with histiocytic infiltrates. These reactions to trichosanthin may be mediated by soluble factors released by HIV-infected macrophages.
authors.affiliation: Department of Neurology, University of California, San Francisco 94143.
authors.forename: P A
authors.initials: PA
authors.lastname: Garcia
authors.forename: D E
authors.initials: DE
authors.lastname: Bredesen
authors.forename: H V
authors.initials: HV
authors.lastname: Vinters
authors.forename: R
authors.initials: R
authors.lastname: Graefin von Einsiedel
authors.forename: R L
authors.initials: RL
authors.lastname: Williams
authors.forename: J O
authors.initials: JO
authors.lastname: Kahn
authors.forename: V S
authors.initials: VS
authors.lastname: Byers
authors.forename: A S
authors.initials: AS
authors.lastname: Levin
authors.forename: L A
authors.initials: LA
authors.lastname: Waites
authors.forename: R O
authors.initials: RO
authors.lastname: Messing
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001037:Aphasia / Q000139:chemically induced* / Q000473:pathology; D001479:Basal Ganglia / Q000187:drug effects / Q000473:pathology; D001921:Brain / Q000187:drug effects / Q000473:pathology*; D003128:Coma / Q000139:chemically induced* / Q000473:pathology; D017809:Fatal Outcome; D005911:Gliosis; D006429:Hemiplegia / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D015978:Trichosanthin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D015978:Trichosanthin