Sugimoto Hideki, Konno Shingo, Takamiya Kiyoshi, Nemoto Hiroshi, Wakata Nobuo, Kurihara Teruyuki
Department of Neurology, Toho University Ohashi Medical Center.
Rinsho Shinkeigaku. 2006 Aug;46(8):561-3.
A 34-year-old man presented with gait disturbance. He had a low grade fever and diarrhea for a few days prior to admission. Two weeks after he started to have diarrhea, he developed gait disturbance with a left foot drop. The cerebrospinal fluid obtained on admission showed pleocytosis (30/microl) and increased protein. The motor nerve conduction velocities (MCV) of the left peroneal nerve and the tibial nerve were slow, but the right peroneal and tibial MCVs were within normal limits. A test for human immunodeficiency virus (HIV) antibody was positive. The Western blot was positive with bands of gp160 and p24, confirming HIV infection. Seroconversion-related neuropathy of HIV was diagnosed. Acute HIV infection should be included in the differential diagnosis of mononeuritis multiplex. Before full-fledged AIDS development, it is important to find early stage of HIV infection in patients, so that we can treat them more effectively by means of anti-HIV drugs.
一名34岁男性出现步态障碍。入院前几天，他有低热和腹泻症状。腹泻开始两周后，他出现步态障碍，伴有左脚下垂。入院时获取的脑脊液显示有细胞增多（30/微升）且蛋白质增加。左侧腓总神经和胫神经的运动神经传导速度（MCV）减慢，但右侧腓总神经和胫神经的MCV在正常范围内。人类免疫缺陷病毒（HIV）抗体检测呈阳性。免疫印迹法显示gp160和p24条带呈阳性，证实为HIV感染。诊断为HIV血清转化相关神经病。急性HIV感染应列入多灶性单神经炎的鉴别诊断。在全面发展为艾滋病之前，在患者中发现HIV感染的早期阶段很重要，这样我们可以通过抗HIV药物更有效地治疗他们。
