Focal monophasic demyelinating leukoencephalopathy in advanced HIV infection.
A multiple sclerosis (MS)-like illness has been reported in human immunodeficiency virus (HIV)-infected patients, usually in the early stages of HIV infection. We report 3 patients with advanced HIV infection (CD4 lymphocyte count under 200/mm(3)) presenting with monophasic focal leukoencephalopathy, in whom biopsy demonstrated demyelinating lesions compatible with acute MS lesions. In 1 patient, recently started on highly active antiretroviral therapy, MS-like disease could represent an immune reconstitution syndrome. The lesions were reversible in 2 patients, but rapidly fatal in the third patient. These cases show that an MS-like disease may present in advanced HIV infection as focal monophasic leukoencephalopathy with either a reversible or fulminating course, mimicking progressive multifocal leukoencephalopathy.
Corral
Iñigo
I
Servicio de Neurología, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Carretera de Colmenar km. 9,1, ES-28034 Madrid, Spain. icorral.hrc@salud.madrid.org
Quereda
Carmen
C
García-Villanueva
Mercedes
M
Casado
José-Luis
JL
Pérez-Elías
María-Jesús
MJ
Navas
Enrique
E
Ariza
Aurelio
A
Moreno
Santiago
S
D000328:Adult; D003711:Demyelinating Diseases / Q000209:etiology* / Q000473:pathology; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods