D'Arma Giuseppe Maria Andrea, Balzano Rosario Francesco, Masino Federica, Guglielmi Giuseppe
Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy.
Radiology Unit, Dimiccoli Hospital, Barletta, Italy.
Encephalitis. 2025 Jan;5(1):15-20. doi: 10.47936/encephalitis.2024.00094. Epub 2024 Dec 13.
We describe the case of a 47-year-old woman who was confused and complained about left-sided weakness when she presented to our institution. The patient underwent a head computed tomography that raised the suspicion of a recent-onset ischemic episode (subacute phase). The patient was admitted to the neurology department and underwent a magnetic resonance imaging (MRI) with contrast medium administration. The clinical and laboratory findings and the MRI features, particularly the presence of a hypointense rim in the susceptibility-weighted imaging (SWI) sequences, were consistent with a diagnosis of progressive multifocal leukoencephalopathy (PML). Immunosuppression was observed as a result of lymphopenia, and the patient was subsequently diagnosed with previously undocumented AIDS. Our aim is to present this rare case of PML in an immunocompromised patient with AIDS, describing the main MRI features and the possible role of SWI sequences.
我们描述了一名47岁女性的病例，她在前来我院就诊时神志不清，并诉说左侧肢体无力。患者接受了头部计算机断层扫描，这引发了对近期发生的缺血性发作（亚急性期）的怀疑。患者被收入神经内科，并接受了静脉注射造影剂的磁共振成像（MRI）检查。临床和实验室检查结果以及MRI特征，特别是磁敏感加权成像（SWI）序列中低信号环的存在，与进行性多灶性白质脑病（PML）的诊断相符。由于淋巴细胞减少观察到免疫抑制，该患者随后被诊断为先前未记录的艾滋病。我们的目的是介绍这例艾滋病免疫功能低下患者中罕见的PML病例，描述主要的MRI特征以及SWI序列可能发挥的作用。
