title: Antiretroviral therapy-associated acute motor and sensory axonal neuropathy.
abstract: Guillain-Barré syndrome (GBS) has been reported in HIV-infected patients in association with the immune reconstitution syndrome whose symptoms can be mimicked by highly active antiretroviral therapy (HAART)-mediated mitochondrial toxicity. We report a case of a 17-year-old, HIV-infected patient on HAART with a normal CD4 count and undetectable viral load, presenting with acute lower extremity weakness associated with lactatemia. Electromyography/nerve conduction studies revealed absent sensory potentials and decreased compound muscle action potentials, consistent with a diagnosis of acute motor and sensory axonal neuropathy. Lactatemia resolved following cessation of HAART; however, neurological deficits minimally improved over several months in spite of immune modulatory therapy. This case highlights the potential association between HAART, mitochondrial toxicity and acute axonal neuropathies in HIV-infected patients, distinct from the immune reconstitution syndrome.
authors.affiliation: Department of Neurology, Children's National Medical Center, The George Washington University School of Medicine, Washington, D.C.
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Capers
authors.forename: Sinan
authors.initials: S
authors.lastname: Turnacioglu
authors.forename: Robert T
authors.initials: RT
authors.lastname: Leshner
authors.forename: John R
authors.initials: JR
authors.lastname: Crawford