Bonnet E, Petit N, Sellier P, Gallais H; International Conference on AIDS.
Int Conf AIDS. 1993 Jun 6-11; 9: 416 (abstract no. PO-B16-1688).
Infectious Diseases Unit, La Conception Hospital, Marseille, France.
A 27 year-old HIV-infected man (risk factor: I.V drug use, stage IIB, CD4 cell count = 560 mm3) developed within 2 months a fast progressive spastic paraparesis. The deficit started by involving the left leg then the arms, then he presented a dysarthria, swallowing troubles and a pseudo-bulbar syndrome. There was an Addison's history, diagnosed at 8 year-old, which remained stable with substitutive opotherapy. HIV related encephalopathy and HTLV I infection were first suspected. The following examinations were performed: routine CSF studies and more specific tests (including CSF electrophoresis and various serologia) were normal, electromyography showed neurogenic deficit of lower limbs, brainstem-evoked responses revealed abnormalities of the brainstem, magnetic resonance imaging of the spinal cord showed slight atrophy and disorder of the auditory tract in the lateral lemniscus, HTLV I serology was negative. Hypothesis of adrenoleukodystrophy (ADL) was at last confirmed by the measurement of long-chain fatty acids. Unfortunately no objective improvement was noted with a specific diet. Usually, time between adrenal insufficiency and neurological disorders related to ADL is much shorter than in our case which can explain the delayed diagnosis and the poor response to treatment. CONCLUSION: Although neurological disorders related to HIV infection are the most frequent in HIV-infected patients, other diagnosis should not be missed.
Publication Types:
Keywords:
- AIDS Dementia Complex
- Acquired Immunodeficiency Syndrome
- Adrenoleukodystrophy
- CD4 Lymphocyte Count
- HIV
- HIV Seropositivity
- HIV-1
- HTLV-I Infections
- Human T-lymphotropic virus 1
- Humans
- Magnetic Resonance Imaging
- Male
- Paraparesis, Spastic
- Risk Factors
- Spinal Cord
- Spinal Cord Diseases
Other ID:
UI: 102204639
From Meeting Abstracts