Motor neuron disease in patients with HIV infection: Report of two cases and brief review of the literature

Lorenzoni, Paulo José; Ducci, Renata Dal‐Prá; Dalledone, Giuliano Ohde; Kay, Cláudia Suemi Kamoi; Almeida, Sérgio Monteiro de; Werneck, Lineü Cesar; Scola, Rosana Hermínia

doi:10.1016/j.clineuro.2018.06.006

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…Combination antiretroviral medications may slow advancement and potentially reverse symptomology of an ALS-like syndrome in HIV-infected individuals [4, 5]. One study observed motor neuron disease is increasingly less progressive and more responsive to HAART as the time from HIV infection to ALS onset increases [9]. Furthermore, it has been proposed that the HIV virus could mutate to selectively infect motor neurons, offering an explanation for the efficacy of HAART in slowing or reversing symptomology, although no direct evidence supports the theory [7].…”

Section: Discussion/conclusionmentioning

confidence: 99%

ALS-Like Disorder in Three HIV-Positive Patients: Case Series

Satin

Bayat

2021

Case Rep Neurol

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There appears to be a relationship between retroviruses such as HIV and the development of an ALS-like syndrome. Few cases have been reported; however, there exists evidence of a higher frequency of motor neuron disease in HIV-infected patients, as well as potential slowing and reversibility of disease course with combination antiretroviral therapy. We conducted a retrospective chart review of patients presenting to the George Washington University ALS Clinic from September 2006 to June 2018 to identify patients with HIV receiving HAART who were subsequently diagnosed with ALS or an ALS-like disorder. Our goals were to describe our patients’ disease course and compare them to general characteristics of ALS. We report three cases of HIV-positive individuals, all male, who were subsequently diagnosed with ALS. Each presented with symptoms of limb onset ALS with involvement of upper and lower motor neurons and whose disease originated at the cervical level. All three had been diagnosed with HIV prior to presentation and were presumably compliant with antiretroviral therapy throughout. Our patients demonstrated effective control of their HIV infection. Each experienced relatively slow progression of motor impairment compared to general ALS characteristics. Our study offers a distinct profile of HIV-positive patients compliant with HAART subsequently diagnosed with an ALS-like disorder. Further study should aim to uncover pathophysiological similarities between motor neuron disease both in the presence and absence of retroviral infection and to develop effective medical therapy for each.

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Section: Discussion/conclusionmentioning

confidence: 99%

ALS-Like Disorder in Three HIV-Positive Patients: Case Series

Satin

Bayat

2021

Case Rep Neurol

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“…This case report present a course of motor-neuron disease in a patient with type I HIV as well as other cases in the literature (Casado et al1997, Galassi et al 1998, Sinha et al2004, Lorenzoni et al 2018. Due the time of evolution and the no improvement of the symptoms with the new antiretroviral treatment we face a case of Amyotrophic Lateral Sclerosis with a very slow progression (Casado et al 1997).…”

Section: Discussionmentioning

confidence: 70%

“…The eatiology has been described as genetic or sporadic, having a high contribution for its pathogenic course. In the last decades, there were some cases of sporadic ALS in patients with infectious disease such like HIV-1 (Galassi et al 1998, Sinha et al 2004, Lorenzoni et al 2018, which help configurating a hypothesis of an infectious aetiology in this cases, with an ALS-like syndrome with predilection for the spinal cord anterior horn cells (Levin SN & Lyons JI, 2018) and, when treated with an specific antiretroviral, has a complete remission (Sinha et al 2004). In 2016 Owens and colleagues identified the activation of HERV-k, an endogenous retrovirus, in this type of patients, with an increase plasma level that received antiretroviral therapy with a good penetrance in the central nervous system and had reversal of symptoms within 6 months of onset of neurologic symptoms.…”

Section: Introductionmentioning

confidence: 99%

Neurosarcoidose: Relato De Caso Em Paciente Com Rebaixamento Do Sensório Associado a Neuropatia De Nervo Craniano, Cefaleia E Vasculopatia

Hämmerle¹,

Souza²,

Botelho³

et al. 2020

Frente Diagnóstica E Terapêutica Na Neurologia 2

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Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição 4.0 Internacional (CC BY 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais.

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“…HIV vacuolar myelopathy was considered, but this usually involves the sensory tracts, which were intact in our patient [7] . HIV can also cause motor neuron disease that can be predominantly upper motor neuron, but this is not very common [8] . Other causes of progressive spastic paraparesis include nutritional deficiencies (B12, copper, vitamin E, folate), toxicities (nitrous oxide, others), or hereditary causes (eg, adult onset adrenomyeloneuropathy, hereditary spastic paraplegia, etc.…”

Section: Discussionmentioning

confidence: 99%