Abstract
A case of biopsy verified progressive multifocal leucoencephalopathy (PML) in an HIV patient is presented. Imaging and histological examination confirmed remarkable inflammatory activity accompanied by an unusually benign clinical course despite no clear evidence of immune reconstitution after the start of antiretroviral treatment. This case not only raises several questions regarding the pathophysiology of PML, but gives also evidence that AIDS associated inflammatory PML must be considered another clinical entity in the expanding range of diseases now commonly referred to as the immune reconstitution syndrome.
MeSH terms
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AIDS Dementia Complex / diagnosis
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AIDS Dementia Complex / drug therapy*
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AIDS Dementia Complex / immunology
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AIDS Dementia Complex / pathology
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AIDS-Related Opportunistic Infections / diagnosis
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AIDS-Related Opportunistic Infections / drug therapy*
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AIDS-Related Opportunistic Infections / immunology
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AIDS-Related Opportunistic Infections / pathology
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Antiretroviral Therapy, Highly Active* / adverse effects
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Biopsy
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Brain / immunology
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Brain / pathology
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CD4 Lymphocyte Count
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Encephalitis / immunology*
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Encephalitis / pathology
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Follow-Up Studies
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Humans
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Image Enhancement
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Leukoencephalopathy, Progressive Multifocal / diagnosis
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Leukoencephalopathy, Progressive Multifocal / drug therapy*
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Leukoencephalopathy, Progressive Multifocal / immunology
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Leukoencephalopathy, Progressive Multifocal / pathology
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Lymphocytes / immunology
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Lymphocytes / pathology
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Macrophages / immunology
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Macrophages / pathology
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Magnetic Resonance Imaging
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Male
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Middle Aged
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Monocytes / immunology
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Monocytes / pathology