Takeuchi Makoto, Nobukuni Keigo, Takata Hiroshi, Kawata Noriko, Hayashibara Noriko, Ishizu Hideki, Takahashi Kiyoshi
Department of Hematology, National Hospital Organization, Minami-Okayama Medical Center, Okayama.
Intern Med. 2005 Jul;44(7):757-60. doi: 10.2169/internalmedicine.44.757.
We report a patient with acquired immunodeficiency syndrome dementia complex (ADC) that presented human immunodeficiency virus infection as an initial manifestation. A 34-year-old man developed disturbance of consciousness and severe abulia over 3 months. The CD4 lymphocyte count was 7.9/microl, while human immunodeficiency virus RNA in blood amounted to 4.2 x 10(4) copies/ml. T2-weighted magnetic resonance imaging showed diffusely high signal intensity in the deep white matter of both cerebral hemispheres. On the 20th hospital day, the patient died of sepsis caused by methicillin-resistant Staphylococcus aureus. Autopsy findings in the brain included increased glial cells and multinucleated giant cells in cerebral white matter and subcortical gray matter. These features were compatible with ADC.
我们报告了一名以获得性免疫缺陷综合征痴呆综合征（ADC）为表现的患者，其最初表现为人类免疫缺陷病毒感染。一名34岁男性在3个月内出现意识障碍和严重的意志缺失。CD4淋巴细胞计数为7.9/微升，而血液中的人类免疫缺陷病毒RNA达4.2×10⁴拷贝/毫升。T2加权磁共振成像显示双侧大脑半球深部白质弥漫性高信号强度。在住院第20天，患者死于耐甲氧西林金黄色葡萄球菌引起的败血症。脑部尸检结果包括脑白质和皮质下灰质中神经胶质细胞增多和多核巨细胞。这些特征符合ADC。
