Sivadasan Ajith, Alexander Mathew, Patil Anil Kumar, Balagopal Krishnan, Azad Zeyaur Rahman
Arch Neurol. 2012 Dec;69(12):1644-7. doi: 10.1001/archneurol.2012.486.
BACKGROUND Case reports of subacute sclerosing panencephalitis (SSPE) in individuals with human immunodeficiency virus (HIV) infection are scarce, and the natural history is unclear. To our knowledge, a fulminant presentation has not yet been described. OBJECTIVE To describe a case of fulminant SSPE in an individual with a perinatally acquired HIV infection. DESIGN Case report and literature review. SETTING Christian Medical College Hospital, Vellore, India. PATIENT A 17-year-old boy with a perinatally acquired HIV infection. RESULTS The patient presented with subacute-onset cognitive decline and myoclonic jerks with rapid deterioration of health (the patient died within 12 weeks of onset). The findings from magnetic resonance imaging and electroencephalography and the cerebrospinal fluid and serum measles antibody titers were suggestive of SSPE. The fulminant presentation in this case needs to be noted. CONCLUSIONS Along with the better life expectancy of HIV-infected individuals, there may be an increase in the incidence of SSPE in this population. Fulminant SSPE may be added to the spectrum of measles-associated neurological disorders in HIV.
背景 关于人类免疫缺陷病毒(HIV)感染个体发生亚急性硬化性全脑炎(SSPE)的病例报告稀少,其自然病史尚不清楚。据我们所知,尚未有暴发性表现的相关描述。目的 描述1例围生期获得性HIV感染个体发生暴发性SSPE的病例。设计 病例报告及文献复习。地点 印度韦洛尔基督教医学院医院。患者 1名17岁围生期获得性HIV感染男孩。结果 患者表现为亚急性起病的认知功能减退和肌阵挛抽搐,健康状况迅速恶化(患者在发病后12周内死亡)。磁共振成像、脑电图以及脑脊液和血清麻疹抗体滴度检查结果提示为SSPE。该病例的暴发性表现值得关注。结论 随着HIV感染个体预期寿命的延长,该人群中SSPE的发病率可能会增加。暴发性SSPE可能会被纳入HIV相关麻疹神经系统疾病谱中。