Progressive multifocal leucoencephalopaty in a patient with aids [Leucoencefalopatía multifocal progresiva en paciente con SIDA. Presentación de un caso]
Progressive Multifocal Leucoencephalopaty (PML) is an untreatable viral infection of the brain white matter, seen in persons with very advanced HIV infection. We report a 28 year-old homosexual man assisted in Córdoba City (Argentina). He started suddenly with fever, seizures and altered mental stat...
Guardado en:
| Autores principales: | , , |
|---|---|
| Formato: | Artículo |
| Lenguaje: | Español |
| Publicado: |
2008
|
| Materias: | |
| Acceso en línea: | http://pa.bibdigital.ucc.edu.ar/4821/1/A_Chalub.pdf |
| Aporte de: |
| Sumario: | Progressive Multifocal Leucoencephalopaty (PML) is an untreatable viral infection of the brain white matter, seen in persons with very advanced HIV infection. We report a 28 year-old homosexual man assisted in Córdoba City (Argentina). He started suddenly with fever, seizures and altered mental status. Then he had focal neurologic defects such as: aphasia and left hemiparesis. Patient also had thrush and skin lesions which resembled Kaposi' sarcoma. Computed Tomography scanning (CT) didn't show important findings, but Magnetic Resonance Imaging (MRI) detected nonenhancing white matter lesions without mass effect on the right side of basal ganglia, suggestive of PML. Cerebral spinal fluid (CSF) findings were normal. HIV tests (ELISA/Western-blot) , were positive and CD4 cell-count was 70/mm3. Stereotactic cerebral biopsy was performed without complications, anatomo-pathological examination and PCR test for the detection of JV Virus, confirmed the diagnosis of PML. KS was also diagnosed by skin biopsy. No treatment has been demonstrated effective for PML so, our patient received HAART (Zidovudine/Lamivudine/ Lopinavir-ritonavir). He gradually experienced progressive improvement during follow-up. Seven years later, his clinical, radiological and virological aspects, have been stabilized. We point out that JC virus may generally affect untreated AIDS-patients. PML doesn't have specific neurologic symptoms, MRI may be typical, but cerebral biopsy, made in some cases, certifies the diagnosis. Finally, we agree with other authors that PML in AIDS-patients may improve with HAART. |
|---|