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[Progressive multifocal leukoencephalopathy in acquired immunodeficiency syndrome]. 1994

A Clavo Sánchez, and D García-Gil, and S Sasián Martínez, and M Geraldía Lama, and A Serrano González, and A Bascuñana Quirell
Unidad de Enfermedades Infecciosas, Hospital Universitario Puerta del Mar, Cádiz.

Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection in HIV-infected persons. We present the characteristics of seven cases of PML, which represent 3.1% of our patients with AIDS. In six cases, was the "marker" disease for AIDS. The most common clinical manifestation was a slowly evolving focal neurological syndrome (average time of pre-hospitalization symptoms was 64 days). The number of T4 lymphocytes at the moment of diagnosis varied between 14 and 121 cel/mm3 (median: 51). Computerized tomography (CT) and cranial nuclear magnetic resonance (NMR) showed images of single (4 cases) or multiple white substance involvement without contrast uptake or mass-effect. The definitive diagnosis was made by cerebral biopsy. Four died within 20 to 90 days of diagnosis. Three of the five who received antiretrovirals survived with apparent stabilization of the process at 2, 13, and 23 months of diagnosis. PML can be an initial diagnostic disease for AIDS. Its symptoms and the CT/NMR should arouse suspicion. However, given that clinicoradiological data are often insufficient, it is advisable to conduct cerebral biopsies. Antiretrovirals may have a favorable effect on diseases course.

UI MeSH Term Description Entries
D007968 Leukoencephalopathy, Progressive Multifocal An opportunistic viral infection of the central nervous system associated with conditions that impair cell-mediated immunity (e.g., ACQUIRED IMMUNODEFICIENCY SYNDROME and other IMMUNOLOGIC DEFICIENCY SYNDROMES; HEMATOLOGIC NEOPLASMS; IMMUNOSUPPRESSION; and COLLAGEN DISEASES). The causative organism is JC Polyomavirus (JC VIRUS) which primarily affects oligodendrocytes, resulting in multiple areas of demyelination. Clinical manifestations include DEMENTIA; ATAXIA; visual disturbances; and other focal neurologic deficits, generally progressing to a vegetative state within 6 months. (From Joynt, Clinical Neurology, 1996, Ch26, pp36-7) Encephalitis, JC Polyomavirus,Progressive Multifocal Leukoencephalopathy,JC Polyomavirus Encephalopathy,Encephalopathies, JC Polyomavirus,Encephalopathy, JC Polyomavirus,JC Polyomavirus Encephalitis,Leukoencephalopathies, Progressive Multifocal,Multifocal Leukoencephalopathies, Progressive,Multifocal Leukoencephalopathy, Progressive,Progressive Multifocal Leukoencephalopathies
D008297 Male Males
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000163 Acquired Immunodeficiency Syndrome An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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