Severe aseptic leucoencephalopathy as immune reconstitution inflammatory syndrome in Caucasian and African patients.
Immune reconstitution inflammatory syndrome (IRIS) after HAART may become manifest in form of aseptic severe leucoencephalopathy. All HIV-1-positive patients in this case series had widespread laboratory tests and follow-up MRI in order to investigate the course and the underlying pathophysiology of IRIS-associated leucoencephalopathy. All patients were treated with corticosteroids, in spite of additional immunosuppression. Three patients were successfully treated with corticosteroids and survived up to now, one died. A neuropathological examination was performed showing massive aseptic intraparenchymal and perivascular invasion of cytotoxic CD8 cells. It is assumed that IRIS-associated leucoencephalopathy is based on other preconditions in Africans and Caucasians.
Department of Neurology, Heinrich Heine University, Duesseldorf, Germany. a.ringelstein@gmx.de
Adrian
A
Ringelstein
Christian
C
Oelschlaeger
Andreas
A
Saleh
Christian
C
Mathys
Rainer
R
Dziewas
Thomas
T
Niederstadt
Doris
D
Reichelt
Martin
M
Hasselblatt
Ingo W
IW
Husstedt
Gabriele
G
Arendt
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D015497:HIV-1; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000276:immunology / Q000821:virology*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D044465:White People
D019380:Anti-HIV Agents