Resumos
Polirradiculoneurite aguda possivelmente causada pelo vírus da imunodeficiência humana, tratada com plasmaferese, é relatada em paciente com anticorpos anti-HIV positivos por enzimaimunoensaio, confirmados pelo Western-blot. Este revelou bandas p-24, p-38 (fraca) e p-119. Sem evidências clínicas de AIDS, o paciente desenvolveu manifestações psico-orgânicas e severa neutropenia medicamentosa. São discutidas: a etiologia da manifestação neurológica na ausência de infecções oportunistas, pela ação própria do retrovirus; a patogenia das lesões desmielinizantes pela resposta imune cruzada entre homologias químicas dos epitopes da proteína P2 e o HIV, nas lesões do sistema nervoso periférico, e entre similaridades dos determinantes entre o vírus com proteína de mielina básica, nas agressões ao sistema nervoso central.
A 50-year-old man with positive test for human immunodeficiency virus (HIV) by enzyme-linked-immunoassay and Western-blot, without clinical manifestations of acquired immunodeficiency syndrome (AIDS), developed acute polyradiculoneuritis and was treated by plasmapheresis with improvement. We believe that chemical homologies of antigenic determinants between HIV and P2 protein of peripheral nervous system and myelin basic protein may induce crossed-reaction, thus developing acute polyradiculoneuritis and central nervous system involvement, respectively. The nervous system involvement hy HIV also occur in the HI-viremy, seric conversion alone, and AIDS with or without oportunistic infections.
Polirradiculoneurite aguda e vírus da imunodeficiência adquirida
Acute polyradiculoneuritis and the human immunodeficiency virus
Milberto ScaffI; Getúlio D. RabelloII; Paulo E. MarchioriII
IDepartamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP): Professor Associado
IIDepartamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP): Assistente
RESUMO
Polirradiculoneurite aguda possivelmente causada pelo vírus da imunodeficiência humana, tratada com plasmaferese, é relatada em paciente com anticorpos anti-HIV positivos por enzimaimunoensaio, confirmados pelo Western-blot. Este revelou bandas p-24, p-38 (fraca) e p-119. Sem evidências clínicas de AIDS, o paciente desenvolveu manifestações psico-orgânicas e severa neutropenia medicamentosa. São discutidas: a etiologia da manifestação neurológica na ausência de infecções oportunistas, pela ação própria do retrovirus; a patogenia das lesões desmielinizantes pela resposta imune cruzada entre homologias químicas dos epitopes da proteína P2 e o HIV, nas lesões do sistema nervoso periférico, e entre similaridades dos determinantes entre o vírus com proteína de mielina básica, nas agressões ao sistema nervoso central.
SUMMARY
A 50-year-old man with positive test for human immunodeficiency virus (HIV) by enzyme-linked-immunoassay and Western-blot, without clinical manifestations of acquired immunodeficiency syndrome (AIDS), developed acute polyradiculoneuritis and was treated by plasmapheresis with improvement. We believe that chemical homologies of antigenic determinants between HIV and P2 protein of peripheral nervous system and myelin basic protein may induce crossed-reaction, thus developing acute polyradiculoneuritis and central nervous system involvement, respectively. The nervous system involvement hy HIV also occur in the HI-viremy, seric conversion alone, and AIDS with or without oportunistic infections.
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Clínica Neurológica, Hospital das Clínicas, FMUSP - Caixa Postal 3561 - 01051 São Paulo SP -Brasil
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Datas de Publicação
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Publicação nesta coleção
06 Jun 2011 -
Data do Fascículo
Mar 1989