Progressive Neurologic Symptoms in the Setting of HIV

Autor:	Laura Eisenmenger, Jesse Manunga, Benjamin D. Sawatzky, Anthony D. Kuner, Howard A. Rowley, James M. Sosman
Rok vydání:	2021
Předmět:	business.industry Lymphocytic pleocytosis Human immunodeficiency virus (HIV) medicine.disease medicine.disease_cause Lymphoma Rare case Immunology medicine Viral rna Neurology (clinical) Sarcoidosis Gait difficulty business Vasculitis
Zdroj:	Neurology. 97:389-390
ISSN:	1526-632X 0028-3878
DOI:	10.1212/wnl.0000000000012238
Popis:	A 54-year-old man with HIV infection on suppressive antiretroviral therapy (ART) presented with progressive gait difficulty over 1 year. MRI demonstrated increasingly predominant white matter hyperintensity and development of abnormal perivascular enhancement (figure 1). An extensive workup excluded atypical infections, CNS lymphoma, sarcoidosis, vasculitis, and other autoimmune diseases. Serum HIV viral RNA was 160 copies/mL; CSF HIV viral RNA was 1,390 copies/mL with a mild lymphocytic pleocytosis, consistent with a diagnosis of neurosymptomatic CSF HIV escape, viral CSF sequestration despite ART.1 Whereas white matter hyperintensity is nonspecific in HIV, the key to CSF HIV escape diagnosis is recognizing the abnormal perivascular enhancement (figure 2).2 Clinical course and imaging findings improved with modified ART targeting neuropenetration.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::5242b816100890884f5cf2676821bbaf https://doi.org/10.1212/wnl.0000000000012238 Zobrazit plný text záznamu