Subject(s)
Acquired Immunodeficiency Syndrome , Child , Child, Preschool , Female , Humans , Infant , PregnancyABSTRACT
Developmental abnormalities in 16 pediatric patients with AIDS or AIDS-Related Complex (ARC) were previously described. Neurological deterioration was in evidence on follow-up in 9 of the children, 5 died since the original assessments were performed. Ten patients were reevaluated 14 months later by cognitive testing. Two showed greater progress than expected on the basis of earlier test results; 6 showed the expected level of developmental progress; and the remaining 2 showed regression in cognitive functioning. All patients who exhibited regression in their developmental course showed deterioration in their neurological examinations. Developmental progression was noted in some children who on follow-up serial examinations exhibited a clinically deteriorating neurological picture. Pediatric AIDS patients manifest variable neurodevelopmental courses. As a result, rehabilitative intervention services must be tailored to meet individual needs.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Central Nervous System Diseases/etiology , Developmental Disabilities/etiology , AIDS-Related Complex/complications , Child , Child, Preschool , Cognition Disorders/etiology , Dementia/etiology , Follow-Up Studies , Humans , InfantABSTRACT
Twenty-five children with acquired immune deficiency syndrome (AIDS) or AIDS-related complex had a characteristic pattern of T cell deficiency. Abnormally low plasma thymulin levels preceded the development of peripheral blood T cell abnormalities. In contrast to patients with congenital T cell deficiencies, our patients had elevated serum levels of thymosin-alpha 1. Treatment with thymosin fraction 5 in three children with AIDS resulted in only transient clinical and immunologic improvement.
Subject(s)
Acquired Immunodeficiency Syndrome/blood , Thymic Factor, Circulating/blood , Thymosin/analogs & derivatives , Thymus Hormones/blood , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/immunology , Child , Child, Preschool , Deltaretrovirus/immunology , Humans , In Vitro Techniques , Infant , T-Lymphocytes/immunology , Thymalfasin , Thymosin/blood , Thymosin/therapeutic useABSTRACT
CT or postmortem examination demonstrated calcification of the basal ganglia in eight infants and children with acquired immune deficiency syndrome. Serial CT studies documented progression of both bilateral symmetric calcium densities and cerebral atrophy. Clinical features included progressive encephalopathy with dementia, and pyramidal tract signs. Postmortem examination of four children revealed variable degrees of calcific vasopathy of the basal ganglia, involving predominantly the putamen and globus pallidus.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnostic imaging , Basal Ganglia/diagnostic imaging , Acquired Immunodeficiency Syndrome/pathology , Basal Ganglia/pathology , Calcinosis/diagnostic imaging , Calcinosis/pathology , Child , Child, Preschool , Female , Humans , Infant , Male , RadiographyABSTRACT
Suppressor T-cell function was analyzed in seven children with acquired autoimmunodeficiency syndrome (AIDS) or AIDS-related complex (ARC). Four of the patients had markedly increased serum IgG levels. All patients had elevated percentages and absolute numbers of peripheral blood T8 cells. In vitro concanavalin A generation of suppressor cells for T-cell mitogenic responses and suppression of pokeweed mitogen-driven immunoglobulin secretion were diminished in all patients. After intravenous treatment with gamma globulin, four patients regained in vitro suppression of pokeweed mitogen-driven gamma globulin secretion. Treatment with intravenous gamma globulin also modified in vitro suppressor T-cell functions in children with AIDS or ARC.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Immunoglobulin G/therapeutic use , T-Lymphocytes, Regulatory/physiology , Child , Child, Preschool , Concanavalin A/pharmacology , Humans , Immunoglobulin G/metabolism , Infant , Injections, Intravenous , Interleukin-2 , L-Lactate Dehydrogenase/blood , Suppressor Factors, ImmunologicABSTRACT
Children with acquired immune deficiency syndrome (AIDS) display two types of clinical picture: a full-blown AIDS characterized by the presence of opportunistic infections and/or Kaposi's sarcoma and a prodromal stage now identified as AIDS-related complex (ARC). Neurological complications have been identified in infants and children with the disease. This paper discusses the developmental abnormalities in 16 pediatric patients, seven with AIDS and nine with ARC, ranging in age from six months to six years. In all cases, the mothers of these children either had ARC, AIDS and/or used intravenous drugs. Developmental histories showed delayed acquisition of milestones in most children following the diagnosis of AIDS or ARC, with delayed motor milestones consistently noted in both groups. Several children with AIDS actually lost milestones as their illness progressed; this has not occurred in the ARC group. Psychometric testing revealed more severe cognitive dysfunction in the group with AIDS. Involvement of the central nervous system was documented clinically, radiologically, and/or electrophysiologically in all patients with AIDS. In the ARC group the course of the illness has shown greater variability. Medical and social factors that may contribute to the developmental abnormalities are discussed.
