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The differential diagnoses were: viral encephalitis; acute disseminated encephalomyelitis; diffusely infiltrative neoplasia; or immune reconstitution inflammatory syndrome (IRIS) of pre-existing progressive multifocal leucoencephalopathy, toxo plasmosis, or HIV-associated neurocognitive disorder (HA...

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Bibliographic Details
Published in:The Lancet (British edition) 2010-03, Vol.375 (9720), p.1134-1134
Main Authors: Holmes, Michael V, Dr, Desai, Mitesh, MRCP, Dosekun, Olamide, MRCP, Holmes, Paul, FRCP, Lucas, Sebastian B, Prof, Kulasegaram, Ranjababu, FRCP
Format: Article
Language:English
Subjects:
AIDS Dementia Complex - complications
AIDS Dementia Complex - diagnosis
Anti-Retroviral Agents - administration & dosage
Biological and medical sciences
Diagnosis, Differential
Drug resistance
Drug therapy
Female
General aspects
HIV
Human immunodeficiency virus
Humans
Immune Reconstitution Inflammatory Syndrome - complications
Immune Reconstitution Inflammatory Syndrome - diagnosis
Internal Medicine
Medical sciences
Middle Aged
Patients
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Summary:The differential diagnoses were: viral encephalitis; acute disseminated encephalomyelitis; diffusely infiltrative neoplasia; or immune reconstitution inflammatory syndrome (IRIS) of pre-existing progressive multifocal leucoencephalopathy, toxo plasmosis, or HIV-associated neurocognitive disorder (HAND). A brain biopsy sample taken on day 24 showed perivascular large CD20-positive B cells (figure B) with 25% proliferation fraction, but Epstein-Barr virus (EBV) encoded RNA negative on in-situ hybridisation.1 There was also marked peri vascular and parenchymal T-cell infiltration (predominantly CD8-positive) and microgliosis (CD68-positive).
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(09)62101-2