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- Title
Polineuropatia desmielinizante inflamatória como primeira manifestação de infecção VIH-1.
- Authors
Speidel, A.; Shamasna, M.; Velho, P.; Coelho, R.; Oliveira, F.; Faria, M. J.; Barros, M. S. J.
- Abstract
We illustrate a clinical case of a 44 yr old male patient with an HIV diagnosis after a polyneuropathy research. He was a previously healthy person who sought health care after he had evolved paresthesia of the lower limbs for two months, followed by a progressive ascending weakness, showing areflexic quadriparesis, dominant on the left side, attaining the facial nerve (VII). A lumbar puncture was made, revealing proteinorrachia (292.59 mg/dl) with lymphocytic pleocytosis (22 cells/mm³). The electromyography gave results in accordance with the diagnosis of inflammatory demyelinating polyneuropathy. Among further results obtained there should be mentioned positive HIV-1 serology (viremia 9697 copies/ml and CD4+ 460/µl). The patient evolved towards a chronical stage of the disease; his condition worsened in spite of being treated with intravenous immunoglobulin. About two months after diagnosis he required mechanical ventilation due to respiratory insufficiency associated to pneumonia. He was kept at the Intensive Care Unit and died after 40 days in hospital with sepsis. This clinical case emphasizes the relevance of searching HIV infection in patients with inflammatory demyelinating polyneuropathy, especially if associated with pleocytosis, which is more common in HIV positive patients.
- Subjects
HIV-positive persons; PARESTHESIA; LUMBAR puncture; HIV infection complications; IMMUNOGLOBULINS; PNEUMONIA
- Publication
RPDI - Revista Portuguesa de Doenças Infecciosas, 2008, Vol 4, Issue 3, p123
- ISSN
0870-1571
- Publication type
Article