Infect Chemother.  2010 Jun;42(3):198-202. 10.3947/ic.2010.42.3.198.

A Case of Immune Reconstitution Inflammatory Syndrome in AIDS-related Progressive Multifocal Leukoencephalopathy after Antiretroviral Therapy

• Ju SH
• Kim TH
• Na JS
• Song HS
• Yu IK
• Yoon HJ

• KMID: 2170311
• DOI: http://doi.org/10.3947/ic.2010.42.3.198

Abstract

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system due to JC virus. In acquired immunodeficiency syndrome (AIDS) patients, JC virus infects myelin-producing oligodendrocytes causing a non-inflammatory lytic reaction leading to demyelination and brain death. We herein report a case of a 56-years-old AIDS man who developed immune reconstitution inflammatory syndrome and died while undergoing highly active antiretroviral therapy. In this patient, the PML involved the brainstem, causing mental confusion followed by recurrent aspiration, adult respiratory distress syndrome, and eventually to early death.

Keyword

Progressive multifocal leukoencephalopathy; Acquired immunodeficiency syndrome; Highly active antiretroviral therapy; Immune reconstitution inflammatory syndrome

MeSH Terms

Acquired Immunodeficiency Syndrome
Antiretroviral Therapy, Highly Active
Brain Death
Brain Stem
Central Nervous System
Demyelinating Diseases
Humans
Immune Reconstitution Inflammatory Syndrome
JC Virus
Leukoencephalopathy, Progressive Multifocal
Oligodendroglia
Respiratory Distress Syndrome, Adult