Suat KAMIŞLI, Özden KAMIŞLI, Sinan GÖNÜLLÜ, Sibel ÇIPLAK

Aıds demans kompleksi olgu sunumu

Edinsel immün yetmezlik sendromu (AIDS) hastalarında sinir sistemitutulumu çok sık görülmektedir. AIDS demans kompleksi (ADC), kognitif vepsikomotor fonksiyonların ilerleyici kötüleşmesi ile karakterize birsendromdur ve çoğu zaman hastalığın terminal döneminde ortaya çıkar.Olgumuza, demans ve parkinsonizm tanıları ile takip ediliyorken kliniğinhızlı ilerleyişi nedeniyle benzer tabloya yol açabilecek etiyolojileraraştırılarak klinik, laboratuvar ve radyolojik tetkikler sonucunda ADC tanısıkonmuştur. Olgumuzu, AIDS tanısının nörolojik komplikasyonları üzerindenkonulmuş olması nedeniyle bildirmeye değer bulduk.

A case report of aids dementia complex

Involvement of nervous system is frequently seen in patients with Acquired Immune Deficiency Syndrome (AIDS). AIDS dementia complex (ADC) is characterized by progressive decline of cognitive and psychomotor functions, and often occurs in the terminal phase of the disease. While our patient was being followed up with the diagnosis of dementia and parkinsonism, clinical signs rapidly progressed. Other conditions that might cause similar symptoms were searched and the patient was diagnosed with ADC based on the clinical, laboratory, and radiological findings. Here, we are reporting a patient with advanced acquired immunodeficiency syndrome (AIDS) who developed dementia as an initial manifestation.

PDF

___

1.Centers for Disease Control and Prevention (CDC). Trends in HIV/AIDS diagnoses among men who have sex with men 33States, 2001-2006. MMWR Morb Mortal Wkly Rep 2008; 57:6816.
2.Koralnik IJ. Neurologic diseases caused by human immuno defici ency virus-1 and opportunistic infections. In: Mandell GL, Bennett JE,Dolin R, (eds.). Mandell, Douglas, and Bennetts Principles and Practice of Infectious Diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2005; 1583-601.
3.Góngora-Rivera F, Santos-Zambrano J, Moreno-Andra de T, Calza daLópez P, Soto- Hernández JL. The clinical spectrum of neurological manifestations in AIDS patients inMexico. Arch Med Res 2000;31:393-8.
4.Budka H. Human immunodeficiency virus (HIV)-induced disease of the central nervous system: pathology and implications for pathogenesis. Acta Neuropathol Berl 1989; 77: 22536.
5.Portegies P, Enting R H, de Gans J, Algra PR, Derix MMA, Lange JMA, et al. Presentation and course of AIDS dementia complex: 10 years of follow-up in Amsterdam, The Netherlands. AIDS 1993; 7:66975.
6.Simpson DM, Berger JR. Neurologic manifestations of HIV infection. Med Clin North Am 1996; 80:1363-94.
7.Geschwind MD, Shu H, Haman A, Sejvar JJ, Miller BL. Rapidly Progressive Dementia.Ann Neurol 2008; 64:97-108.
8.Roberson ED, Hesse JH, Rose KD, et al. Frontotemporal dementia progresses to death faster than Alzheimer disease. Neurology 2005;65:71925.
9.Rascovsky K, Salmon DP, Lipton AM, et al. Rate of progression differs in frontotemporal dementia and Alzheimer disease. Neurology 2005;65:397403.
10.Cercy SP, Bylsma FW. Lewy bodies and progressive dementia: a critical review and metaanalysis. JInt Neuropsychol Soc 1997;3:17994.
11.Holloway RG, Kieburtz JKD. In: Mandell GL, Bennett JE, Dolin R, eds. Neurologic manifestations of HIV infection. Mandell, Douglasand Bennetts Principles and Practice of Infectious Diseases. 4th ed. New York: Churchil Living stone; 2000: 1432-9.
12.Teja VD, Talasila SR, Vemu L. Neurologic manifestations of HIV infection: an Indian hospital based study. AIDS Read 2005;15:139-43.
13.Yan YF,Wang ZY,Pu SS, Wen HL,Huang T,Song YY et al. HIV-1B gp120 genes from one patient with AIDS dementia complex can affect the secretion of tumor necrosis factor and interleukin 1β in glial cells. Chin Med J(Engl) 2011;124:4217-22.
14.Price RW. Understanding the AIDS dementia complex (ADC). The challenge of HIV and its effects on the central nervous system. Res Publ Assoc Res Nerv Ment Dis 1994; 72:145.
15.Epstein LG, Gendelman HE. Human immunodeficiency virus type 1infection of the nervous system: Pathogenetic mechanisms. Ann Neurol 1993;33: 42936.
16.Burger DM, Kraaijeveld CL, Meenhorst PL, Mulder JW, Koks CH, Bult A et al. Penetration of zidovudine into the cerebrospinal fluid of patients infected with HIV.AIDS 1993; 7:15817.
17.Lewis PR. Merritts Neurology Tenth Edition. Lippincott Williams &Wilkins, Philadelphia, 2000: 1637.
18.Powers A. Diabetes mellitus. In: Kasper DL, Fauci AS, Longo D, et al., editors.Harrison's principles of internal medicine. 16th ed. New York: McGraw-Hill;2005:216970.
19.Blank LJ, Polydefkis MJ, Moore RD,Gebo KA. Herpes zoster among persons living with HIV in the current antiretroviral therapy era. J Acquir Immune Defic Syndr 2012;61:203-7.