Leucopatía reversible de la protuberancia: en paciente con SIDA y tratamiento retroviral / Pontine reversible leucopathy in an AIDS patient associated with highly active antiretroviral therapy (HAART): report of one case
Rev. méd. Chile
; 144(5): 675-679, mayo 2016. ilus, tab
Article
em Es
| LILACS
| ID: lil-791057
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CL1.1
ABSTRACT
Posterior reversible encephalopathy (PRES) is a condition characterized by T2 and FLAIR hyperintensities in magnetic resonance imaging (MRI) studies, localized preferentially in the occipital-parietal white matter regions. Pathological MRI images located in midbrain, pons, medulla and spinal cord, that could be asymptomatic, were recently included in this entity. These images are interpreted as vasogenic edema, which is caused by arterial hypertension or eclampsia, neurotoxicity related to immunosuppressive agents or chemotherapy, among other causes. We report a 25 years old asymptomatic male with AIDS, with normal blood pressure who after initiating highly active antiretroviral therapy (HAART) reported vertigo. The MRI showed a central pontine T2 hyperintensity with diffusion restriction, which was interpreted as a central pontine myelinolysis (CPM), but the lack of motor symptoms made improbable a real demyelination of the pons. The follow-up MRI revealed complete regression of the images. To our knowledge, this case could be the second report of a reversible leucopathy of the pons in a patient with AIDS, were the MRI images also simulated a CPM. This report extends the knowledge around the variability of the pathogenic interpretation of CPM images and their association with HAART.
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1
Índice:
LILACS
Assunto principal:
Síndrome da Imunodeficiência Adquirida
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Terapia Antirretroviral de Alta Atividade
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Síndrome da Leucoencefalopatia Posterior
Tipo de estudo:
Risk_factors_studies
Limite:
Adult
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Humans
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Male
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2016
Tipo de documento:
Article