Addison's disease and severe encephalopathy in an infant with HIV infection.
OBJECTIVE
To discuss the overlapping clinical spectrum of encephalopathy due to Addison's disease and HIV infection.


METHODS
We report a 2.5-year-old boy from Uzbekistan with recurrent episodes of encephalopathy and seizures, triggered by infection or vaccinations, in whom adrenal insufficiency and infection with HIV and HCV was diagnosed. Presumably, Addisonian crises prompted hypovolemic shock and blood transfusions, which were responsible for horizontal HIV infection. The combination of adrenal insufficiency and HIV infection eventually led to progressive severe encephalopathy. Despite highly active antiretroviral therapy (which led to substantial reduction of blood viral load), the neurological condition did not improve.


CONCLUSIONS
The interactions of Addison's disease and HIV in the pathogenesis of encephalopathy are discussed.
Beblo
Skadi
S
Universitätsklinik und Poliklinik für Kinder und Jugendliche, Universität Leipzig, Leipzig, Germany. Skadi.Beblo@medizin.uni-leipzig.de
Allmendinger
Johannes
J
Pfäffle
Roland
R
Strehlau
Jürgen
J
Schulz
Manuela
M
Wintergerst
Uwe
U
Schuster
Volker
V
Kiess
Wieland
W
Merkenschlager
Andreas
A
D015526:AIDS Dementia Complex / Q000150:complications* / Q000473:pathology; D000224:Addison Disease / Q000150:complications*; D023241:Antiretroviral Therapy, Highly Active; D002675:Child, Preschool; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D012769:Shock / Q000209:etiology / Q000628:therapy; D065227:Transfusion Reaction; D016896:Treatment Outcome; D014610:Uzbekistan / Q000208:ethnology