Dardis Christopher
Department of Neurology , Barrow Neurological Institute , Phoenix, AZ , USA.
Oxf Med Case Reports. 2015 Feb 26;2015(2):200-2. doi: 10.1093/omcr/omv009. eCollection 2015 Feb.
Acute inflammatory demyelinating polyneuropathy or Guillain-Barré syndrome is well recognized as a presenting feature of human immunodeficiency virus (HIV) seroconversion and, to a lesser extent, as a complication of HIV infection, particularly immune reconstitution. Acute motor axonal neuropathy (AMAN) is much rarer in this setting. A case is presented of acute motor neuropathy, with features most consistent with AMAN in the setting of congenital HIV and prolonged non-compliance with antiretroviral treatment. The case throws new light on the pathogenesis of this condition. Macrophage activation is proposed as fundamental; the patient was predisposed by HIV as well as the use of granulocyte colony-stimulating factor and AMAN was then precipitated by a bacterial infection.
急性炎症性脱髓鞘性多发性神经病或吉兰-巴雷综合征是公认的人类免疫缺陷病毒（HIV）血清转换的表现特征，在较小程度上也是HIV感染的并发症，尤其是免疫重建相关并发症。急性运动轴索性神经病（AMAN）在这种情况下更为罕见。本文报告一例急性运动神经病病例，其特征在先天性HIV及长期未坚持抗逆转录病毒治疗的背景下与AMAN最为相符。该病例为这种疾病的发病机制提供了新的线索。巨噬细胞激活被认为是其发病基础；该患者因HIV以及使用粒细胞集落刺激因子而具备发病倾向，随后因细菌感染引发了AMAN。
