Schwenk J, Gosztonyi G, Thierauf P, Iglesias J, Langer E
Institut für Neuropathologie, Freie Universität Berlin, Federal Republic of Germany.
J Neurol. 1990 Nov;237(7):445-7. doi: 10.1007/BF00314738.
Two non-alcoholic homosexual patients with acquired immunodeficiency syndrome (AIDS) are reported who developed acute Wernicke's encephalopathy in the terminal stage of their illness. The first patient presented with vascular congestion, minute haemorrhages, proliferation of microglia and of the vessel walls at the predilection sites of the Wernicke-Korsakoff process. In the second patient only the mamillary bodies were involved. Besides Wernicke's encephalopathy, a primary cerebral immunoblastoma and cerebral toxoplasmosis were found in the first patient, whereas the second showed severe encephalitis with numerous microglial and multinucleated giant cells reacting positively with anti-HIV antibody. Just as in the development of Wernicke's encephalopathy in malignant diseases, the catabolic trend of the metabolism of the immunodeficient patients with consecutive thiamine deficiency must be considered the principal pathogenetic mechanism.
报告了两名患获得性免疫缺陷综合征（艾滋病）的非酒精性同性恋患者，他们在疾病终末期出现急性韦尼克脑病。首例患者在韦尼克-科尔萨科夫病变的好发部位出现血管充血、微小出血、小胶质细胞及血管壁增生。第二例患者仅乳头体受累。首例患者除韦尼克脑病外，还发现原发性脑免疫母细胞瘤和脑弓形虫病，而第二例表现为严重脑炎，有大量小胶质细胞和多核巨细胞，抗HIV抗体反应呈阳性。正如恶性疾病中韦尼克脑病的发生情况一样，免疫缺陷患者代谢的分解代谢趋势以及随之而来的硫胺素缺乏必须被视为主要的发病机制。
