Primary HIV infection presenting with Kaposi sarcoma and limbic encephalitis.
J Neurovirol
; 26(2): 292-296, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-31768888
ABSTRACT
The development of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is often associated with neoplasia or infectious diseases as antibodies against neurons or synaptic proteins surface. A 30-year-old male patient was admitted to our department because of neurocognitive symptoms, particularly memory difficulties which had appeared a year prior and since then had been increasing. He had a medical history of smoking and hypertension. On examination, there were no focal neurological deficits. However, neuropsychological tests confirmed a lack of concentration and short-term memory impairment. Brain magnetic resonance imaging (MRI) and electroencephalography (EEG) remained unremarkable. Cerebrospinal fluid (CSF) analysis revealed a low lymphocytic pleocytosis without oligoclonal bands. Serum testing for human immunodeficiency virus (HIV) was positive with 420,000 HIV-1-RNA copies/ml. On a more detailed physical examination, a large number of purple patches were found on the entire body, which a biopsy confirmed to be Kaposi sarcoma (KS). A positive serum and CSF NMDA receptor antibody titer (serum 1280; CSF 18) confirmed the diagnosis of an AIDS-associated anti-NMDA receptor encephalitis; therefore, we treated him with antiretroviral and immunosuppressive therapy. After 12 months, the KS lesions faded and the cognitive deficits improved slightly. Our case highlights that a detailed clinical examination and searching for neoplasia and/or an infection are helpful, though often neglected, tools for detecting an anti-NMDA receptor encephalitis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Sarcoma de Kaposi
/
Infecciones por VIH
/
Encefalitis Límbica
/
Encefalitis Antirreceptor N-Metil-D-Aspartato
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
J Neurovirol
Asunto de la revista:
NEUROLOGIA
/
VIROLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania