Progressive multifocal leukoencephalopathy in a child with acquired immunodeficiency syndrome (AIDS)

Abstract

Progressive multifocal leukoencephalopathy is a rare viral-induced demyelinating disease associated to immunodeficiency. A 10-year-old boy with AIDS is reported, who developed subacute cerebellar signs and symptoms with multiple cranial nerve involvement and dementia. A computed tomography scan revealed a focal nonenhancing area of low attenuation in the cerebellum. On magnetic resonance imaging high signal lesions in T2 weighted sequences were shown. The biopsy of one of those lesions showed the typical histological findings of progressive multifocal leukoencephalopathy. It seems important to consider this diagnosis in children with AIDS who present with progressive neurological features.

Progressive Multifocal Leukoencephalopathy in HIV-Infected Children: A Case Report and Literature Review

“…Since 1992 there have been reports of 14 HIV-infected children having PML (Table 1) [4–14]. Overall, PML in HIV-infected children has occurred mostly in boys (9/14, 75%), with a median age of 10 years (range: 7–17).…”

Progressive Multifocal Leukoencephalopathy in Pediatric Patients

“…34, 44 Among the reported cases in HIV-infected children, none had pleocytosis and all had a normal glucose (48-92 mg/dL) and a normal to slightly elevated protein (12-76 mg/dL). 6, 10, 11, 13-16, 19, 20, 23, 34 Among case reports in children without HIV, the CSF profiles, including cell count, glucose, and protein, were also within normal limits. 26, 28, 30-32 …”

“…6, 8-23 Of the 19 published reports, 12 patients acquired HIV via vertical maternal-to-child transmission, 4 via blood product transfusions, 1 from a contaminated needle, and 1 from an orthotopic liver transplant. The source of infection for one child was not reported.…”

Progressive Multifocal Leukoencephalopathy as a Presenting Manifestation of Acquired Immunodeficiency Syndrome in a Child

“…Extensive search of the MEDLINE database and Google Scholar search engine using the terms "leukoencephalopathy" and "acquired immunodeficiency syndrome" or "human immunodeficiency virus" showed the presence of only 12 reported cases of progressive multifocal leukoencephalopathy in children with human immunodeficiency virus infection [3][4][5][6][7][8][9][10][11][12][13]. Five of these cases were girls [4,5,7,9,10] and seven were boys [3,[6][7][8][11][12][13]. The age of the patients at presentation with progressive multifocal leukoencephalopathy ranged from 6 to 17 years, with 3 of the girls presenting at an age of 13 years [7,9,10].…”