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- Title
Primary HIV infection presenting with Kaposi sarcoma and limbic encephalitis.
- Authors
Kaddu-Mulindwa, Dominic; Roth, Sophie; Klees-Rollmann, Aline; Fassbender, Klaus; Fousse, Mathias
- Abstract
The development of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is often associated with neoplasia or infectious diseases as antibodies against neurons or synaptic proteins surface. A 30-year-old male patient was admitted to our department because of neurocognitive symptoms, particularly memory difficulties which had appeared a year prior and since then had been increasing. He had a medical history of smoking and hypertension. On examination, there were no focal neurological deficits. However, neuropsychological tests confirmed a lack of concentration and short-term memory impairment. Brain magnetic resonance imaging (MRI) and electroencephalography (EEG) remained unremarkable. Cerebrospinal fluid (CSF) analysis revealed a low lymphocytic pleocytosis without oligoclonal bands. Serum testing for human immunodeficiency virus (HIV) was positive with 420,000 HIV-1-RNA copies/ml. On a more detailed physical examination, a large number of purple patches were found on the entire body, which a biopsy confirmed to be Kaposi sarcoma (KS). A positive serum and CSF NMDA receptor antibody titer (serum 1:280; CSF 1:8) confirmed the diagnosis of an AIDS-associated anti-NMDA receptor encephalitis; therefore, we treated him with antiretroviral and immunosuppressive therapy. After 12 months, the KS lesions faded and the cognitive deficits improved slightly. Our case highlights that a detailed clinical examination and searching for neoplasia and/or an infection are helpful, though often neglected, tools for detecting an anti-NMDA receptor encephalitis.
- Subjects
INFECTION; KAPOSI'S sarcoma; ANTI-NMDA receptor encephalitis; HIV infections; ENCEPHALITIS; METHYL aspartate receptors; CEREBROSPINAL fluid examination; AIDS
- Publication
Journal of NeuroVirology, 2020, Vol 26, Issue 2, p292
- ISSN
1355-0284
- Publication type
Article
- DOI
10.1007/s13365-019-00815-1