Progressive multifocal leucoencephalopathy with unusual inflammatory response during antiretroviral treatment.
A case of biopsy verified progressive multifocal leucoencephalopathy (PML) in an HIV patient is presented. Imaging and histological examination confirmed remarkable inflammatory activity accompanied by an unusually benign clinical course despite no clear evidence of immune reconstitution after the start of antiretroviral treatment. This case not only raises several questions regarding the pathophysiology of PML, but gives also evidence that AIDS associated inflammatory PML must be considered another clinical entity in the expanding range of diseases now commonly referred to as the immune reconstitution syndrome.
Hoffmann
C
C
University of Kiel, Chemnitztrasse 33, 24116 Kiel, Germany. c.hoffmann@med2.uni-kiel.de
Horst
H-A
HA
Albrecht
H
H
Schlote
W
W
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001706:Biopsy; D001921:Brain / Q000276:immunology / Q000473:pathology; D018791:CD4 Lymphocyte Count; D004660:Encephalitis / Q000276:immunology* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007968:Leukoencephalopathy, Progressive Multifocal / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology; D008264:Macrophages / Q000276:immunology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000473:pathology