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Multiple complications of late - stage HIV infection - A case Report E.P. Verrengia, A. Romorini, P. Mantegazza, M.V. Calloni, P. Perrone |
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Proceedings SNO |
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Introduction: HIV/AIDS-related neurological disease can include opportunistic infections, progressive multifocal leukoencephalopathy, HIV-dementia, HIV associated malignancies mostly affecting the central nervous system, peripheral neuropathies. Methods: We present a case of unusual first neurological manifestation of HIV infection. Results: A 41 yrs Albanian man was admitted to our Hospital with a lower motor neuron facial nerve palsy and headache. He reported cervical and lumbar pain started one month before. Neurological examination revealed a disturbance of right-sided facial and trigeminal nerve palsy, lower motor neuron signs in his left arm and right leg. Cerebral magnetic resonance showed nasopharynx material with mucosal hyperplasia and neck lymphadenopathy; HIV was detected from blood samples; cerebro-spinal fluid confirmed HIV high level antibodies and showed cellular increase (50/µL lynphocites). One day after admission he developed dysphonia and dysarthria suggesting a glosso-pharyngeal and vagus nerves involvement. After 7 days of hospitalization, during antiretroviral therapy, he died for coronary dissection. Small B-cell Lymphoma affecting nerves, myocardium, kidneys, adrenal glands was detected by autopsy. Conclusions: Multiple mononeuropathies in our patient affected by HIV disease was related to lymphoma; differential diagnosis includes diffuse infiltrative lyphocytosis syndrome (DILS), opportunistic infections, necrotizing vasculitis. Bibliography: 1. Gabbai A.A., Castelo A., Oliveira A.S.: HIV peripheral neuropathy. Handb Clin Neurol 2013; 115 515-529. 2. Kelly J.J., Karcher D.S.: Lymphoma and peripheral neuropathy: a clinical review. Muscle Nerve 2005; 31 (3): 301-313. 3. Woodcock H., Nelson M.: Burkitt's non-Hodgkins lymphoma presenting as facial nerve palsy in HIV-positive patients. Int J STD AIDS 2011; 22 (2): 112-114. |
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Articles from "Proceedings" are provided here courtesy of |
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Proceedings SNO - ISBN 978-88-8041 - Copyright © 2017 SNO & new MAGAZINE s.r.l. - Italy |
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