Cerebral aneurysms in a child with acquired immune deficiency syndrome during rapid immune reconstitution.
A 12-year-old boy with perinatally acquired human immunodeficiency virus infection an d Centers for Disease Control and Prevention class C3 disease presented with acute onset of confusion and a right-sided movement disorder 5 months after beginning a new antiretroviral regimen. His CD4 count had been below 50 cells/microL for 4 years but had abruptly risen to more than 250 cells/microL. Computed tomographic and magnetic resonance imaging scans showed cerebral aneurysms and new cerebral lesions consistent with ischemic strokes. The presentation during immune reconstitution suggests that cerebral aneurysms in pediatric patients with acquired immune deficiency syndrome can result from an immune-mediated response to chronic vascular infection.
Bonkowsky
Joshua L
JL
Department of Pediatrics, University of Utah, Salt lake City 84132, USA.
Christenson
John C
JC
Nixon
G William
GW
Pavia
Andrew T
AT
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D000998:Antiviral Agents / Q000008:administration & dosage*; D018791:CD4 Lymphocyte Count; D002648:Child; D003221:Confusion / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000998:Antiviral Agents