Opsoclonus-myoclonus in an HIV-infected child on antiretroviral therapy-possible immune reconstitution inflammatory syndrome

Date
2005
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The exact immunopathogenesis and neuroanatomical localization of opsoclonus-myoclonus ataxia syndrome remains unclear. We describe a 1 year 9 month old girl who, shortly after commencement of highly active antiretroviral therapy developed opsoclonus-myoclonus syndrome and subsequently died of disseminated cytomegalovirus infection. We postulate on the etiological factors that may have played a role in the disease pathogenesis of the patient's opsoclonus-myoclonus ataxia. Immune reconstitution inflammatory syndrome was considered the most likely because of the initial CD4 depletion and the onset of symptoms shortly after initiation of antiretroviral therapy. Single photon emission computed tomography (SPECT) proved helpful by localizing the area of dysfunction to the cerebellar vermis. © 2005 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Description
Keywords
antiretrovirus agent, CD4 antigen, corticotropin, ganciclovir, hexamethylpropylene amine oxime technetium tc 99m, immunoglobulin, lamivudine, lopinavir plus ritonavir, stavudine, article, ataxia, case report, cause of death, cerebellum vermis, cytomegalovirus infection, female, helper cell, highly active antiretroviral therapy, human, Human immunodeficiency virus infection, immunopathogenesis, immunopathology, inflammation, lymphocyte depletion, myoclonus, neuroanatomy, opsoclonus, preschool child, priority journal, single photon emission computer tomography, Adrenocorticotropic Hormone, Anti-Inflammatory Agents, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Electroencephalography, Fatal Outcome, Female, HIV Infections, HIV-1, Humans, Infant, Inflammation, Paraneoplastic Syndromes, Nervous System, Reverse Transcriptase Polymerase Chain Reaction, Tomography, X-Ray Computed
Citation
European Journal of Paediatric Neurology
9
6