Human immunodeficiency virus seroconversion presenting with acute inflammatory demyelinating polyneuropathy: a case report.
BACKGROUND
Acute Human Immunodeficiency Virus infection is associated with a range of neurological conditions. Guillain-Barré syndrome is a rare presentation; acute inflammatory demyelinating polyneuropathy is the commonest form of Guillain-Barré syndrome. Acute inflammatory demyelinating polyneuropathy has occasionally been reported in acute Immunodeficiency Virus infection but little data exists on frequency, management and outcome.


METHODS
We describe an episode of Guillain-Barré syndrome presenting as acute inflammatory demyelinating polyneuropathy in a 30-year-old man testing positive for Immunodeficiency Virus, probably during acute seroconversion. Clinical suspicion was confirmed by cerebrospinal fluid analysis and nerve conduction studies. Rapid clinical deterioration prompted intravenous immunoglobulin therapy and early commencement of highly active anti-retroviral therapy. All symptoms resolved within nine weeks.


CONCLUSIONS
Unusual neurological presentations in previously fit patients are an appropriate indication for Immunodeficiency-Virus testing. Highly active anti-retroviral therapy with adequate penetration of the central nervous system should be considered as an early intervention, alongside conventional therapies such as intravenous immunoglobulin.
Sloan
Derek J
DJ
Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, Liverpool, UK. dereksloan@hotmail.com
Nicolson
Andrew
A
Miller
Alastair R O
AR
Beeching
Nick J
NJ
Beadsworth
Mike B J
MB