Top

Published in:

01-02-2017 | clinical report

Atypical presentations of acute disseminated encephalomyelitis (ADEM) in HIV infection

Authors: Ansuya Naidoo, Hoosain Paruk, Bhupendra Bhagwan, Anand Moodley

Published in: Journal of NeuroVirology | Issue 1/2017

Abstract

Acute disseminated encephalomyelitis is a monophasic demyelinating disorder of the central nervous system associated with various viral infections including HIV infection. We present the findings of seven HIV-infected patients with mild to moderate immunosuppression presenting with atypical features. Four patients had a multiphasic course; three patients had tumefactive lesions, and two patients had corpus callosum lesions. Two patients with the multiphasic course also had tumefactive lesions. Their clinical and radiological findings are presented. Despite the few cases, we propose that the dysimmune process lying between marked immunosuppression (CD4 < 200 cells/μL) and normal CD4 counts (CD4 > 500 cells/μL) might be responsible for these atypical presentations.

Allen SH, Malik O, et al. (2002) Acute demyelinating encephalomyelitis (ADEM) in a patient with HIV infection. J Infect 45(1):62–64CrossRefPubMed

Bhigjee AI, Patel VB, et al. (1999) HIV and acute disseminated encephalomyelitis. S Afr Med J 89(3):283–284PubMed

Carne CA, Tedder RS, et al. (1985) Acute encephalopathy coincident with seroconversion for anti-HTLV-III. Lancet 2(8466):1206–1208CrossRefPubMed

Dale RC, de Sousa C, et al. (2000) Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children. Brain 123(Pt 12):2407–2422CrossRefPubMed

Gendelman HE, Wolinsky JS, et al. (1984) Measles encephalomyelitis: lack of evidence of viral invasion of the central nervous system and quantitative study of the nature of demyelination. Ann Neurol 15(4):353–360CrossRefPubMed

Koelman DL, Mateen FJ (2015) Acute disseminated encephalomyelitis: current controversies in diagnosis and outcome. J Neurol 262(9):2013–2024CrossRefPubMed

Koelman DL, Chahin S, et al. (2016) Acute disseminated encephalomyelitis in 228 patients: a retrospective, multicenter US study. Neurology 86(22):2085–2093CrossRefPubMed

Koprowski H (1962) The role of hyperergy in measles encephalitis. Am J Dis Child 103:273–278PubMed

Krupp LB, Tardieu M, et al. (2013) International pediatric multiple sclerosis study group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 19(10):1261–1267CrossRefPubMed

Kuhlmann T, Lassmann H, et al. (2008) Diagnosis of inflammatory demyelination in biopsy specimens: a practical approach. Acta Neuropathol 115(3):275–287CrossRefPubMedPubMedCentral

Liu JG, Qiao WY, et al. (2012) Clinical features and neuroimaging findings of 12 patients with acute disseminated encephalomyelitis involved in corpus callosum. Zhonghua Yi Xue Za Zhi 92(43):3036–3041PubMed

McAdam LC, Blaser SI, et al. (2002) Pediatric tumefactive demyelination: case series and review of the literature. Pediatr Neurol 26(1):18–25CrossRefPubMed

Rahmlow MR, Kantarci O (2013) Fulminant demyelinating diseases. Neurohospitalist 3(2):81–91CrossRefPubMedPubMedCentral

Schwarz S, Mohr A, et al. (2001) Acute disseminated encephalomyelitis: a follow-up study of 40 adult patients. Neurology 56(10):1313–1318CrossRefPubMed

Takanashi J, Hirasawa K, et al. (2006) Reversible restricted diffusion of entire corpus callosum. J Neurol Sci 247(1):101–104CrossRefPubMed

Tan HM, Chan LL, et al. (2004) Monophasic, solitary tumefactive demyelinating lesion: neuroimaging features and neuropathological diagnosis. Br J Radiol 77(914):153–156CrossRefPubMed

Tavazzi E, Magrassi L, et al. (2011) Acute transient inflammatory leukoencephalopathy in HIV. Neurol Sci 32(5):899–902CrossRefPubMed

Thajeb P, Chen ST (1989) Cranial computed tomography in acute disseminated encephalomyelitis. Neuroradiology 31(1):8–12PubMed

Tullu MS, Patil DP, et al. (2011) Human immunodeficiency virus (HIV) infection in a child presenting as acute disseminated encephalomyelitis. J Child Neurol 26(1):99–102CrossRefPubMed

Zhang L, Wu A, et al. (2014) Comparison of deep gray matter lesions on magnetic resonance imaging among adults with acute disseminated encephalomyelitis, multiple sclerosis, and neuromyelitis optica. Mult Scler 20(4):418–423CrossRefPubMed

Title: Atypical presentations of acute disseminated encephalomyelitis (ADEM) in HIV infection
Authors: Ansuya Naidoo
Hoosain Paruk
Bhupendra Bhagwan
Anand Moodley
Publication date: 01-02-2017
Publisher: Springer International Publishing
Published in: Journal of NeuroVirology / Issue 1/2017
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-016-0481-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Atypical presentations of acute disseminated encephalomyelitis (ADEM) in HIV infection

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2017

Adult-onset opsoclonus-myoclonus syndrome due to West Nile Virus treated with intravenous immunoglobulin

HIV and decreased risk of multiple sclerosis: role of low CD4+ lymphocyte count and male prevalence

Development and characterization of a human microglia cell model of HIV-1 infection

Evaluating the accuracy of self-report for the diagnosis of HIV-associated neurocognitive disorder (HAND): defining “symptomatic” versus “asymptomatic” HAND

Immortalization of primary microglia: a new platform to study HIV regulation in the central nervous system

Specific amino acids in HIV-1 Vpr are significantly associated with differences in patient neurocognitive status