Konaté A, Ceballos P, Rivière S, Faucherre V, Ciurana A J, Le Quellec A
Service de médecine interne A, hôpital Saint-Eloi, 80, avenue Augustin-Fliche, 34295 Montpellier, France.
Rev Med Interne. 2001 Oct;22(10):988-91. doi: 10.1016/s0248-8663(01)00458-1.
Spinal cord lesions are an uncommon mode of discovering acquired immunodeficiency syndrome because they usually appear at a later stage.
We report a 58-year-old patient who had a spastic paraparesia and sphincter dysfunction. The spinal cord magnetic resonance imaging showed spontaneous hypersignals on T2-weighted images at the cervical and thoracic levels, enhanced with gadolinium, and without swelling. No cause was found. The HIV serology was positive and allowed us to consider an HIV-associated myelopathy. The antiretroviral therapy led to functional recovery.
An HIV serology is suggested whenever an unexplained intramedullary lesion is discovered. Indeed, the diagnosis of HIV-associated myelopathy implies a specific therapeutic approach.
脊髓病变是发现获得性免疫缺陷综合征的一种不常见方式,因为它们通常出现在疾病后期。
我们报告一名58岁患者,其患有痉挛性截瘫和括约肌功能障碍。脊髓磁共振成像显示在T2加权图像上,颈段和胸段出现自发性高信号,钆增强后有强化,且无肿胀。未发现病因。HIV血清学检查呈阳性,使我们考虑为HIV相关性脊髓病。抗逆转录病毒治疗导致功能恢复。
每当发现不明原因的髓内病变时,建议进行HIV血清学检查。事实上,HIV相关性脊髓病的诊断意味着一种特定的治疗方法。