Li Yuanyuan, Yang Qianru, Lin Hong, Zhou Qiong, Ge Fangfang, Shi Jiankuan
Department of Neurology, Xi'an International Medical Center Hospital, xitai road, gaoxin District, Xi'an city, Shaanxi Province, China.
AIDS Res Ther. 2024 Dec 31;21(1):102. doi: 10.1186/s12981-024-00695-4.
Human immunodeficiency virus (HIV) is a retrovirus mainly infecting immune cells. Central nervous system diseases in HIV-infected patients can be caused by HIV or opportunistic infections. Neurological diseases associated with HIV have diverse manifestations and may occur in early or late stages. This article reports an HIV patient with myelopathy as initial symptom and negative spinal cord magnetic resonance imaging (MRI) and reviews common classifications of HIV-related spinal cord diseases.
A 50-year-old male presented with weakness in both lower limbs and gait disorders for more than three months. Physical examination and various tests ruled out many possible causes. Given positive HIV and syphilis antibody in serological examination, normal spinal cord MRI and electromyogram, and after excluding other potential diagnoses through comprehensive analysis, the diagnosis of HIV-related myelopathy was established.
Spinal cord lesions caused by HIV infection involve multiple aspects in terms of etiology and mechanism. HIV infection-related vacuolar myelopathy (HIV-VM) is the most common and typical spinal cord lesion. It usually appears at a relatively late stage of HIV infection, but it may also occur in the early stage and even serve as the initial manifestation of newly diagnosed HIV. The diagnosis of HIV myelopathy is usually exclusionary. In imaging, it often shows high T2 signal and spinal cord atrophy on spinal cord MRI, or it may also appear normal.
Not applicable.
人类免疫缺陷病毒（HIV）是一种主要感染免疫细胞的逆转录病毒。HIV感染患者的中枢神经系统疾病可由HIV或机会性感染引起。与HIV相关的神经疾病表现多样，可发生在疾病早期或晚期。本文报道一例以脊髓病为首发症状且脊髓磁共振成像（MRI）阴性的HIV患者，并回顾HIV相关脊髓疾病的常见分类。
一名50岁男性出现双下肢无力和步态障碍3个多月。体格检查和各项检查排除了许多可能的病因。血清学检查HIV和梅毒抗体呈阳性，脊髓MRI和肌电图正常，经综合分析排除其他潜在诊断后，确诊为HIV相关脊髓病。
HIV感染引起的脊髓病变在病因和机制方面涉及多个方面。HIV感染相关空泡性脊髓病（HIV-VM）是最常见和典型的脊髓病变。它通常出现在HIV感染相对较晚的阶段，但也可能发生在早期，甚至作为新诊断HIV的首发表现。HIV脊髓病的诊断通常是排除性的。在影像学上，脊髓MRI常显示T2高信号和脊髓萎缩，也可能表现正常。
不适用。
