RESUMEN
The aim of the study was to detect neurological abnormalities in human immunodeficiency virus (HIV) infected children. This was achieved by a prospective evaluation, from November/1995 to April/2000, of 43 HIV infected children (group I) and 40 HIV seroreverters children (group II) through neurological exam and neurodevelopmental tests: Denver Developmental Screening Test (DDST) and Clinical Adaptive Test / Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS). A control group (III), of 67 children, were evaluated by CAT/CLAMS. Hyperactivity, irritability and hypotonia were the findings on neurological examination, without statistical differences between group I and II. On CAT/CLAMS, the group I developmental quotient (DQ) was significantly lower than the other groups. The same occurred in DDST, with group I presenting significantly more failures than group II. Nineteen HIV children of group I had brain computed tomographic scan, with abnormalities in three of them (basal ganglia calcification, white matter hypodensity and asymmetry of lateral ventricles). We conclude that in HIV infected children a neurodevelopment delay occur early in the disease, and it can be detected by screening tests
Asunto(s)
Recién Nacido , Lactante , Preescolar , Niño , Humanos , Masculino , Femenino , Discapacidades del Desarrollo/diagnóstico , Infecciones por VIH/complicaciones , Transmisión Vertical de Enfermedad Infecciosa , Estudios de Casos y Controles , Desarrollo Infantil , Estudios Transversales , Discapacidades del Desarrollo/etiología , Estudios de Seguimiento , Pruebas Auditivas , Infecciones por VIH/transmisión , Seronegatividad para VIH , Desarrollo del Lenguaje , Pruebas Neuropsicológicas , Estudios Prospectivos , Tomografía Computarizada por Rayos XRESUMEN
Relatamos nossa experiência com imunoglobulina endovenosa (IGEV), plasmaferese e terapêutica de suporte no tratamento de 13 pacientes com síndrome de Guillain-Barré (SGB). Dos 13 pacientes, 7 receberam IGEV, 2 plasmaferese e 4 terapêutica de suporte. No 15 dia após a administraçäo da IGEV, todos os pacientes deste grupo apresentaram melhora de pelo menos 1 grau na escala de Hughes et al. modificada. Dos 2 pacientes submetidos a plasmaferese, 1 apresentou melhora de 1 grau 5 dias após o procedimento. Entre os 4 pacientes que receberam tratamento de suporte, 2 apresentaram melhora dentro de 20 dias de evoluçäo. No grupo que recebeu IGEV os escores finais foram menores e näo houve recidivas. Assim, estes resultados sugerem que a IGEV diminui o tempo necessário para a melhora clínica quando comparado com tratamento suportivo