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[获得性免疫缺陷综合征中的巨细胞病毒性脑脊髓神经根炎]

[Cytomegalovirus encephalo-myelo-radiculitis in acquired immunodeficiency syndrome].

作者信息

Chimelli L, de Freitas M R, Bazin A R, Mhiri C, Scaravilli F, Gray F

机构信息

Departamento de Patologia, Hospital Antônio Pedro, RJ, Brasil.

出版信息

Rev Neurol (Paris). 1990;146(5):354-60.

PMID:2164701
Abstract

A 30 year-old male, with the acquired immune deficiency syndrome (AIDS) presented with rapidly progressive flaccid paraplegia and sphincter incontinence. Cerebrospinal fluid examination showed elevated protein and pleocytosis. Death occurred 2 months after the onset of neurological signs. Post-mortem examination showed inflammatory necrotic lesions, relatively sparing the axons and predominantly involving the roots of the cord. Numerous cytomegalovirus (CMV) inclusion bodies were found in the necrotic lesions, in the subarachnoid spaces and in Schwann cells. CMV encephalitis and involvement of the 3rd cranial nerves were also observed. Only 8 well-documented clinico-pathological cases of acute CMV myeloradiculitis, which all presented as progressive cauda equina syndrome, have been reported until now in AIDS patients.

摘要

一名30岁男性,患有获得性免疫缺陷综合征(艾滋病),出现快速进展的弛缓性截瘫和括约肌失禁。脑脊液检查显示蛋白升高和细胞增多。神经症状出现2个月后死亡。尸检显示有炎性坏死病变,相对 sparing 轴突,主要累及脊髓神经根。在坏死病变、蛛网膜下腔和施万细胞中发现大量巨细胞病毒(CMV)包涵体。还观察到CMV脑炎和第三对脑神经受累。迄今为止,在艾滋病患者中仅报告了8例记录良好的急性CMV脊髓神经根炎临床病理病例,均表现为进行性马尾综合征。

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