Remission of HIV myelopathy after highly active antiretroviral therapy

Rocco, Alessandro Di; Geraci, Anthony; Tagliati, Michele; Staudinger, Roland; Henry, Katherine

doi:10.1212/wnl.55.3.456

Cited by 22 publications

(5 citation statements)

References 16 publications

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“…Still, they did not report any improvement of spastic paraparesis and urinary incontinence [ 10 ], and they did not write the method to measure the improved symptoms and signs. Other authors also declare a complete recovery of HIV-VM symptoms and signs after being treated with highly active antiretroviral therapy [ 18 , 19 ]. Still, the procedure to measure the improvements is also questionable.…”

Section: Discussionmentioning

confidence: 99%

Atypical HIV-vacuolar myelopathy: a case report

et al. 2021

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Background Here, we report an atypical HIV-vacuolar myelopathy and search the available medical literature about atypical presentations of human immunodeficiency virus associate vacuolar myelopathy (HIV-VM) and immunoglobulin therapy response. Case A 26-year-old lady who was 4 weeks postpartum presented to us with acute flaccid quadriparesis, with no sensory level. Extensive workup ruled out other causes of myelopathy. She developed a stage 3 acute kidney injury, and MRI showed diffuse cord atrophy involving the lower cervical and thoracic cord. The patient received IV-immunoglobulin, ARVs, and supportive therapy with inadequate response. Unfortunately, she developed nosocomial pneumonia and died. Discussion In HIV-VM, there is spinal cord atrophy, which mainly involves the thoracic cord. In our case, this pathological process also affected the spinal cord's cervical region, leading to flaccid tetraplegia, with high CD4 level, without response to the treatment, including intravenous immunoglobulin. Keynotes Vacuolar myelopathy, HIV, Immunoglobulin therapy, flaccid tetraplegia, hypokalaemia. Renal failure.

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Section: Discussionmentioning

confidence: 99%

Atypical HIV-vacuolar myelopathy: a case report

et al. 2021

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“…While the initiation of HAART generally improves some central nervous system (CNS) disease, its impact on the specific neurological complications of HIVM remains controversial and may not prevent progression of the disease. 5,6,9,[12][13][14]17 Reports of improvement in myelopathy are few in number, and some cases have reported improvement of spasticity. Highlights from the 2013 Conference on Retroviruses and Opportunistic Infections (CROI) reference several studies that demonstrate that active disease may progressively damage the CNS despite treatment.…”

Section: Discussionmentioning

confidence: 99%

HIV-associated vacuolar myelopathy: A rare initial presentation of HIV

Rezaie

Parmar

Rendon

et al. 2020

SAGE Open Medical Case Reports

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HIV-associated vacuolar myelopathy, or AIDS-associated myelopathy, is a rare initial presentation of HIV. One of the common HIV-associated neurocognitive disorders, HIV-associated vacuolar myelopathy presents with advanced immunosuppression in patients and is frequently associated with dementia. However, most cases are subclinical with characteristic findings identified through physical examination and/or imaging modalities. HIV-associated vacuolar myelopathy is characterized by progressive spastic paraparesis, gait disturbance and lower extremity sensory abnormalities including vibratory sensation. Magnetic resonance imaging findings in the spinal cord are abnormal in some patients with HIV-associated myelopathy, characteristically showing spinal cord atrophy at the level of the thoracic spine, but they may also be normal. Unfamiliarity with this as initial presentation of HIV infection may lead to failure to diagnose and intervene appropriately. We present a case of newly diagnosed HIV with myelopathy and dementia with minimal spinal cord involvement on magnetic resonance imaging.

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“…We like to highlight the study done by Cikurel et al because it is the only report delivering a number of cases of HIV-VM treated and an important number of improvements (n = 17) after being treated with Ig at the dosage of 2 g/kg for two days of IV infusion but they did not report any improvement of spastic paraparesis and urinary incontinence [10] and they did not report the method to measure the improved symptoms and signs. Other authors also report a complete recovering of symptoms and signs from HIV-VM after being treated with highly active antiretroviral therapy [18,19] but the procedure to measure the improvements are also questionable.…”

Section: No Other Determinable Cause For Spinal Cord Disease By Serolmentioning

confidence: 99%

Atypical HIV-Vacuolar Myelopathy. Case Report and Literature Review.

Tau¹,

Joseph²,

George³

et al. 2020

Preprint

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Background: Here, we report an atypical presentation of HIV-vacuolar myelopathy and search the available medical literature about atypical presentations of human immunodeficiency virus associate vacuolar myelopathy (HIVVM) and immunoglobulin therapy response.Case: A 26-year-old lady who was four weeks postpartum presented to us with acute flaccid quadriparesis, with no sensory level. Extensive workup ruled out other causes of myelopathy. She developed a stage 3 acute kidney injury, and MRI showed diffuse cord atrophy involving the lower cervical and thoracic cord. The patient received IV-immunoglobulin, ARV's, and supportive therapy with inadequate response. Unfortunately, she developed nosocomial pneumonia and died. Discussion: In HIV-VM, there is spinal cord atrophy, which mainly involves the thoracic cord. In our case, this pathological process also affected the spinal cord's cervical region, leading to flaccid tetraplegia, no responding to the treatment, including intravenous immunoglobulin.

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Remission of HIV myelopathy after highly active antiretroviral therapy

Cited by 22 publications

References 16 publications

Atypical HIV-vacuolar myelopathy: a case report

Atypical HIV-vacuolar myelopathy: a case report

HIV-associated vacuolar myelopathy: A rare initial presentation of HIV

Atypical HIV-Vacuolar Myelopathy. Case Report and Literature Review.

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Remission of HIV myelopathy after highly active antiretroviral therapy

Cited by 22 publications

References 16 publications

Atypical HIV-vacuolar myelopathy: a case report

Atypical HIV-vacuolar myelopathy: a case report

HIV-associated vacuolar myelopathy: A rare initial presentation of HIV

Atypical HIV-Vacuolar Myelopathy.&nbsp;Case Report and Literature Review.

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Atypical HIV-Vacuolar Myelopathy. Case Report and Literature Review.