Anti-retroviral therapy-induced status epilepticus in "pseudo-HIV serodeconversion".
Diligence in the interpretation of results is essential as information gained from the psychiatric patient's history might often be restricted. Nonobservance of established guidelines may lead to a wrong diagnosis, induce a false therapy and result in life-threatening situations. Communication errors between hospitals and doctors and uncritical acceptance of prior diagnoses add substantially to this problem. We present a patient with alcohol-related dementia who received anti-retroviral therapy that promoted a non-convulsive status epilepticus. HIV serodeconversion was considered after our laboratory result yielded a HIV-negative status. Critical review of previous diagnostic investigations revealed several errors in the diagnosis of HIV infection leading to a "pseudo-serodeconversion." Finally, anti-retroviral therapy could be discontinued.
Etgen
Thorleif
T
Department of Neurology, Klinikum Traunstein, D- 83278 Traunstein, Germany. thorleif.etgen@klinikum-traunstein.de
Eberl
Bernhard
B
Freudenberger
Thomas
T
D015492:AIDS Serodiagnosis; D000425:Alcohol Amnestic Disorder / Q000175:diagnosis / Q000188:drug therapy; D019380:Anti-HIV Agents / Q000627:therapeutic use* / Q000633:toxicity*; D003299:Cooperative Behavior; D003704:Dementia / Q000175:diagnosis* / Q000188:drug therapy*; D003951:Diagnostic Errors; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010348:Patient Care Team; D011744:Pyrimidinones / Q000009:adverse effects / Q000627:therapeutic use; D019438:Ritonavir / Q000009:adverse effects / Q000627:therapeutic use; D013226:Status Epilepticus / Q000139:chemically induced*; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D019259:Lamivudine; D061466:Lopinavir; D011744:Pyrimidinones; D019438:Ritonavir; D000099227:Abacavir