ABSTRACT
Good's syndrome (GS) is an immunodeficiency characterized by thymoma, hypogammaglobulinemia, and impaired T-cell function. The clinical manifestations of GS include recurrent or chronic infections from common or opportunistic pathogens. Encephalitis is a rare event, with only anecdotal reports of cytomegalovirus infection. Herein we report the case of a 79-year-old woman with GS who developed subacute motor deficits and cognitive changes. Magnetic resonance imaging (MRI) of the brain disclosed white- and gray-matter lesions, mostly in the right frontal and parietal areas. Polyoma virus JC, the agent of progressive multifocal encephalopathy (PML), was identified in cerebrospinal fluid samples and brain biopsy specimens. After diagnosis, the disease had a rapid fatal course. The present case represents the first reported association between GS and PML.
Subject(s)
Immunologic Deficiency Syndromes/complications , JC Virus/isolation & purification , Leukoencephalopathy, Progressive Multifocal/complications , Aged , Brain/pathology , Fatal Outcome , Female , Humans , Immunohistochemistry , Immunologic Deficiency Syndromes/pathology , Leukoencephalopathy, Progressive Multifocal/pathology , Leukoencephalopathy, Progressive Multifocal/virologyABSTRACT
The aim of this retrospective study was to determine the relevance of the symptom "headache" in kidney transplanted patients, since few studies have considered headache as a clinically significant complication in this condition. A total of 83 consecutive kidney transplant patients underwent to neurological examination and a detailed headache history was taken. The headache history considered the period before kidney disease, during renal failure, during dialysis treatment and after transplantation. Diagnosis was made according to International Headache Criteria (ICDH-II) (2004). Our results reveal an occurrence of headache after kidney transplantation in 44.5% of the patients, which is higher than rates reported for the general population and in the only specific comparable study on liver transplant patients. These data suggest the need for prospective studies to explore the causal mechanisms by which headache develops with frequency in kidney transplant patients, and in particular to determine the role of immunosuppressive therapy.
Subject(s)
Headache Disorders/epidemiology , Headache Disorders/etiology , Immunosuppressive Agents/adverse effects , Kidney Transplantation/adverse effects , Postoperative Complications/physiopathology , Adolescent , Adult , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Causality , Cyclosporine/administration & dosage , Cyclosporine/adverse effects , Dialysis/adverse effects , Dose-Response Relationship, Drug , Female , Headache Disorders/physiopathology , Humans , Immunosuppressive Agents/administration & dosage , Incidence , Male , Middle Aged , Prednisone/administration & dosage , Prednisone/adverse effects , Renal Insufficiency/complications , Retrospective Studies , Young AdultSubject(s)
Adrenergic beta-Agonists/therapeutic use , Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/drug therapy , Clenbuterol/therapeutic use , Adrenergic beta-Agonists/adverse effects , Adult , Aged , Clenbuterol/adverse effects , Female , Humans , Male , Middle Aged , Pilot Projects , Treatment OutcomeABSTRACT
Many current accounts of the origin of intrusions and other confabulatory-like phenomena emphasize the role of a retrieval or postretrieval deficit in these disorders. In the experiments reported herein we examine whether the presence of an interfering task at encoding elicits more intrusions in normal subjects than the presence of an interfering task at retrieval. In Experiment 1, performance in story recall without interference was compared to the performance with an interfering task at retrieval. In Experiment 2, the performance in story recall with an interfering task at encoding was compared to performance in story recall with interference at encoding and retrieval. Results suggest that interference at retrieval has no effect on the accuracy of recall and on intrusions. Interference at encoding compared to interference at encoding and retrieval (Experiment 2) had no effect on the accuracy of recall and on frequency of intrusions. Cross-experiment comparisons suggest that interference at encoding affects both the accuracy of retrieval and the probability of intrusions in recall. These results suggest that encoding processes, more than retrieval processes, have a role in eliciting intrusions.
