Department of General Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Neurol India. 2021 Jul-Aug;69(4):1018-1020. doi: 10.4103/0028-3886.325348.
A 45-year-old man presented with acute onset ataxia for last 1 week. On examination he had signs of left-sided cerebellar involement. MRI brain revealed asymmetric altered signal intensities in bilateral cerebellar hemispheres suggesting demyelinating lesions. ELISA for Human Immune Deficiency virus-1 was positive. CSF JC virus DNA PCR was positive. A diagnosis of Progressive Multifocal Leukoencephalopathy (PML) was made on the basis of clinico-radiological picture and JC virus DNA PCR presence in CSF. PML is unknown and under diagnosed CNS infection seen in HIV patients mostly seen with advanced disease. We present an unusual case report where isolated cerebellar involvement occurred as the first AIDS defining event in the absence of appreciable immunodeficiency in a patient with previously undiagnosed HIV infection.
一位 45 岁男性，于过去一周内突发急性共济失调。检查发现左侧小脑受累。脑部 MRI 显示双侧小脑半球信号强度不对称改变，提示脱髓鞘病变。人类免疫缺陷病毒 1 的 ELISA 检测呈阳性。CSF 巨细胞病毒 DNA PCR 阳性。根据临床-影像学表现和 CSF 中 JC 病毒 DNA PCR 的存在，诊断为进行性多灶性白质脑病（PML）。PML 是一种未知的、诊断不足的中枢神经系统感染，在 HIV 患者中较为常见，主要见于晚期疾病患者。我们报告了一个不常见的病例，在未诊断的 HIV 感染患者中，孤立性小脑受累作为首例 AIDS 定义性事件发生，且免疫缺陷不明显。
