Journal
EUROPEAN NEUROLOGY
Volume 52, Issue 1, Pages 36-41Publisher
KARGER
DOI: 10.1159/000079416
Keywords
human immunodeficiency virus; multiple sclerosis; leukoencephalopathy; demyelinating disorders
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A multiple sclerosis (MS)-like illness has been reported in human immunodeficiency virus (HIV)-infected patients, usually in the early stages of HIV infection. We report 3 patients with advanced HIV infection ( CD4 lymphocyte count under 200/mm(3)) presenting with monophasic focal leukoencephalopathy, in whom biopsy demonstrated demyelinating lesions compatible with acute MS lesions. In 1 patient, recently started on highly active antiretroviral therapy, MS-like disease could represent an immune reconstitution syndrome. The lesions were reversible in 2 patients, but rapidly fatal in the third patient. These cases show that an MS-like disease may present in advanced HIV infection as focal monophasic leukoencephalopathy with either a reversible or fulminating course, mimicking progressive multifocal leukoencephalopathy. Copyright (C) 2004 S. Karger AG, Basel.
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