==================================BSR27==================================
27. AIDS (acquired immune deficiency syndrome) and central nervous
system- especially subacute encephalitis, AIDS encephalopathy,
AIDS dementia.
And peripheral nervous system.
1
UI - 87123733
AU - Piazza E ; Condorelli A ; Arcidiacono R ; Tropea R ; Chiaramonte I ;
Mancuso P
TI - Intracerebral mass lesions in patients affected by AIDS.
AB - "Toxoplasma gondii: cerebral abscess is a common opportunistic infection
in patients affected by AIDS. Making a reliable diagnosis of acute
cerebral toxoplasmosis is difficult in AIDS patients because of the lack
of specificity of serological data and neuroradiological findings. Brain
biopsy is the only procedure which enables a reliable diagnosis to be
made a trial of specific medical therapy for toxoplasmosis in patients
affected by AIDS and intracranial mass lesion can be advisable before
performing brain biopsy. The authors report the cases of three patients
affected by AIDS and cerebral toxoplasmosis. Tissue diagnosis was made in
the first patient from autopsy material while a presumptive diagnosis was
made in the other two cases since specific medical therapy resulted in a
dramatic improvement of the neurological status. Despite the good
possibilities in the treatment of this complication AIDS, however,
carries a poor prognosis.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Brain Abscess/
*ETIOLOGY/RADIOGRAPHY ; Case Report ; Human ; Male ; Opportunistic
Infections/*ETIOLOGY/RADIOGRAPHY ; Tomography, X-Ray Computed ;
Toxoplasmosis/*ETIOLOGY/RADIOGRAPHY
SO - Acta Neurochir (Wien) 1986;83(3-4):116-20
2
UI - 87120106
AU - Hagberg L ; Malmvall BE ; Svennerholm L ; Alestig K ; Norkrans G
TI - Guillain-Barr:e syndrome as an early manifestation of HIV central nervous
system infection.
AB - Two cases of HIV infection associated with Guillain-Barr:e syndrome are
described. The neurologic symptoms started 1 week and 20 weeks,
respectively, after the primary HIV infection. Seroconversion for
anti-HIV occurred during the disease. A rapid spread of virus to the
central nervous system was shown.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Aged ; Antibodies,
Viral/ANALYSIS ; Case Report ; Human ; HTLV-III/IMMUNOLOGY ; Male ;
Middle Age ; Polyradiculoneuritis/*COMPLICATIONS
SO - Scand J Infect Dis 1986;18(6):591-2
3
UI - 87093715
AU - Mills J
TI - Pneumocystis carinii and Toxoplasma gondii infections in patients with
AIDS.
AB - Pneumocystis carinii and Toxoplasma gondii are the commonest protozoans
causing infections in patients with acquired immunodeficiency syndrome
(AIDS). P. carinii is almost exclusively a pulmonary pathogen and caused
the commonest serious infection experienced by AIDS patients. The
clinical findings are those of progressive pneumonia. Diagnosis requires
microscopic examination of lower respiratory secretions or lung tissue.
Pentamidine or combinations of trimethoprim and sulfamethoxazole are
equally effective (85% recovery), but about one-half of patients thus
treated experience severe toxicity. T. gondii infections occur primarily
in the brain; patients present with focal seizures or neurologic deficit
and have focal abnormalities as assessed by computed tomography.
Serologic tests for toxoplasmosis are rarely diagnostic in AIDS patients,
and most patients are treated empirically with a combination of
pyrimethamine and sulfonamide. Less invasive diagnostic tests and better
chemotherapeutic agents are required for both pneumocystosis and
toxoplasmosis.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Brain Diseases/
DIAGNOSIS/*ETIOLOGY ; Human ; Opportunistic Infections/*ETIOLOGY ;
Pneumonia, Pneumocystis Carinii/DRUG THERAPY/*ETIOLOGY ; Review ;
Support, Non-U.S. Gov't ; Toxoplasmosis/DIAGNOSIS/*ETIOLOGY
SO - Rev Infect Dis 1986 Nov-Dec;8(6):1001-11
4
UI - 87086188
AU - Milam SB ; Rees TD ; Leiman HI
TI - An unusual cause of bilateral mental neuropathy in an AIDS patient.
Report of a case.
AB - A case is reported of a patient with sudden onset, generalized toothache
accompanied with a numb chin and lower lip. A thorough oral examination
was negative. A complete medical evaluation revealed a positive HTLV-III
antibody titer and acute lymphoblastic leukemia (Burkitt's-type). An
unexplained trigeminal neuropathy should prompt the dentist to refer the
patient for complete medical evaluation. A high index of suspicion of a
malignant process should be maintained in all cases of unexplained numb
lower lip and/or chin.
MH - *Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Acute Disease ; Adult
; Case Report ; Human ; Leukemia, Lymphoblastic/COMPLICATIONS ; Male ;
Paresthesia/*ETIOLOGY ; Peripheral Nerve Diseases/ETIOLOGY ; Sensation ;
Toothache/*ETIOLOGY ; *Trigeminal Nerve
SO - J Periodontol 1986 Dec;57(12):753-5
5
UI - 87085675
AU - Rosemberg S ; Lopes MB ; Tsanaclis AM
TI - Neuropathology of acquired immunodeficiency syndrome (AIDS). Analysis of
22 Brazilian cases.
AB - The neuropathologic study of 22 Brazilian cases of acquired
immuno-deficiency syndrome (AIDS) was performed. Thirteen cases (59%)
showed neuropathologic lesions. These included infection by Toxoplasma (n
= 4), Cryptococcus neoformans (n = 3), viral encephalitis (n = 4),
primary lymphomas (n = 2), isolated cerebral infarct (n = 1), and
reactive gliosis (n = 1). In 2 cases, primary lymphoma and viral
encephalitis were associated. Axonal spheroids in the gracilis and
cuneatus nuclei were present in a case of toxoplasmosis. Mammillary
bodies lesions consistent with Wernicke's encephalopathy were found in a
case of viral encephalitis. In addition, circulatory changes (focal
cortical infarcts) were associated lesions in 3 cases. These findings
were compared with the main series reported in American and European
literature.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/OCCURRENCE ;
Adolescence ; Adult ; Brain Abscess/ETIOLOGY/PATHOLOGY ; Brain Diseases/
ETIOLOGY/*PATHOLOGY ; Brain Neoplasms/ETIOLOGY/PATHOLOGY ; Brain/
*PATHOLOGY ; Brazil ; Cryptococcosis/PATHOLOGY ; Human ; Lymphoma/
ETIOLOGY/PATHOLOGY ; Male ; Middle Age ; Toxoplasmosis/PATHOLOGY
SO - J Neurol Sci 1986 Dec;76(2-3):187-98
6
UI - 87082578
AU - Faulstich ME
TI - Acquired immune deficiency syndrome: an overview of central nervous
system complications and neuropsychological sequelae.
AB - The Acquired Immune Deficiency Syndrome (AIDS) has been associated with a
series of central nervous system (CNS) complications, including focal and
nonfocal neurological indications. Overall, the most common form of CNS
dysfunction is diffuse cerebral atrophy pathologically characterized by
neuronal loss, glial nodules, and microfocal demyelination. Consequent
neuropsychological deficits present an insidious course initially
typified by poor memory and concentration, along with psychomotor
retardation and blunted affect which resembles psychological depression.
Gradually over several weeks to months, patients exhibit marked global
cognitive impairment and can become severely disoriented and delusional.
Clinical research relevant to these CNS complications and
neuropsychological sequelae are reviewed.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Central Nervous
System Diseases/*COMPLICATIONS ; Human ; Organic Mental Disorders/
*ETIOLOGY ; Review
SO - Int J Neurosci 1986 Nov;30(4):249-54
7
UI - 87079218
AU - Schlitt MJ ; Morawetz RB ; Bonnin JM ; Zeiger HE ; Whitley RJ
TI - Brain biopsy for encephalitis.
AB - Brain biopsy is justified in patients suspected of having encephalitis or
viral encephalopathy because those patients are most likely to be helped
if a diagnosis is made rapidly and with the greatest certainty possible.
Neurosurgeons are occasionally reluctant to undertake brain biopsy
because the procedure is diagnostic rather than therapeutic in intent.
However, using currently available techniques a 1 cm3 sample of brain
tissue can be taken with very low risk of morbidity or mortality. We
recommend that the sample be taken from the anterior portion of the
inferior temporal gyrus on the more affected side in patients with herpes
simplex encephalitis, and from an area of maximum demonstrated
involvement in other situations, using stereotactic techniques and
intraoperative ultrasound as necessary. The risk to the operating surgeon
and to the other members of the operating team appears very low in all of
the situations discussed in this chapter. However, the authors feel that
every patient should be approached as if he carries the hepatitis B
virus. As indicated, the incidence of contracting hepatitis B after
sustaining needle stick exposure to blood from persons positive for
hepatitis B surface antigen is 10-15%. Conjunctival contamination by
splash from the wound is a known method of inoculation of surgeons with
hepatitis B virus and is a possible means for transmission of other viral
diseases. We recommend that every patient be approached as if he has
hepatitis B, not because the agent diseases discussed are known to be as
infectious as hepatitis B, but because constant vigilance and careful
technique offer the best protection to the surgeon and the members of the
operating team in most situations, and because one can never be certain
what agent diseases a given patient may harbor. With the exception of the
Creutzfeldt-Jakob virus, the agents responsible for all of the viral
diseases discussed are inactivated by standard procedures for
sterilization of operating room instruments. Procedures necessary to
inactivate the Creutzfeldt-Jakob disease virus have been presented. In
the report documenting transmission of Creutzfeldt-Jakob disease through
human growth hormone preparations the authors state, "We are once again
dramatically reminded that human tissues are a source of infectious
disease, and that any therapeutic transfer of tissue from one person to
another carries an unavoidable risk of transferring the
infection.(ABSTRACT TRUNCATED AT 400 WORDS)
MH - Acquired Immunodeficiency Syndrome/PATHOLOGY ; Biopsy ; Brain/*PATHOLOGY
; Diagnosis, Differential ; Encephalitis/*PATHOLOGY ; Herpes Simplex/
PATHOLOGY ; Human ; Immunologic Deficiency Syndromes/PATHOLOGY ;
Jakob-Creutzfeldt Syndrome/PATHOLOGY ; Leukoencephalopathy, Progressive
Multifocal/PATHOLOGY ; Opportunistic Infections/PATHOLOGY
SO - Clin Neurosurg 1986;33:591-602
8
UI - 87074738
AU - So YT ; Beckstead JH ; Davis RL
TI - Primary central nervous system lymphoma in acquired immune deficiency
syndrome: a clinical and pathological study.
AB - Twenty cases of primary lymphoma of the central nervous system associated
with acquired immune deficiency syndrome were seen over a period of four
years and were studied clinically and pathologically. Biopsy established
the diagnosis in 11 cases, and autopsy confirmed it in 9. Multicentricity
was demonstrated in all cases for which there was adequate autopsy
material. Both large-cell immunoblastic and small noncleaved lymphomas
were seen, and marker studies in 5 patients established that the
lymphomas were of B-cell origin. Neurological symptoms and signs,
cerebrospinal fluid characteristics, and radiographic appearance were
reviewed. The clinical and radiographic picture is nonspecific and
histological confirmation is essential for diagnosis. Although the tumor
appears to be radiosensitive, prognosis is extremely poor, with an
average survival of less than two months.
MH - Acquired Immunodeficiency Syndrome/CEREBROSPINAL FLUID/*COMPLICATIONS ;
Adult ; Brain Neoplasms/ETIOLOGY/*PATHOLOGY ; Brain/PATHOLOGY/RADIOGRAPHY
; Human ; Lymphoma/*ETIOLOGY/PATHOLOGY ; Male ; Middle Age ; Nuclear
Magnetic Resonance/DIAGNOSTIC USE ; Support, Non-U.S. Gov't ; Support,
U.S. Gov't, P.H.S. ; Tomography, X-Ray Computed
SO - Ann Neurol 1986 Nov;20(5):566-72
9
UI - 87063797
AU - Epstein LG ; Sharer LR ; Gajdusek DC
TI - Hypothesis: AIDS encephalopathy is due to primary and persistent
infection of the brain with a human retrovirus of the lentivirus
subfamily.
AB - Recent evidence has demonstrated that human T-lymphotropic retroviruses
are present in the brain of patients with acquired immunodeficiency
syndrome (AIDS). Studies by neuropathological, ultrastructural and
nucleic acid hybridization techniques indicate that these human
retroviruses are neurotropic as well as lymphotropic. Striking
similarities to the animal retroviruses of the lentivirus subfamily
provide a rationale to implicate these human retroviruses (lentiviruses)
in the pathogenesis of AIDS encephalopathy.
MH - Acquired Immunodeficiency Syndrome/*ETIOLOGY/MICROBIOLOGY/PATHOLOGY ;
Adult ; Animal ; Child ; Disease Models, Animal ; Encephalitis/*ETIOLOGY/
MICROBIOLOGY/PATHOLOGY ; Human ; HTLV-III/ISOLATION & PURIFICATION ;
*Models, Biological ; Review
SO - Med Hypotheses 1986 Sep;21(1):87-96
10
UI - 87045329
AU - Brun B ; Boesen F ; Gerstoft J ; Nielsen JO ; Praestholm J
TI - Cerebral computed tomography in men with acquired immunodeficiency
syndrome.
AB - Cerebral CT scannings were performed in 19 homosexual men with the
acquired immunodeficiency syndrome (AIDS). Nearly half of them (9
patients) had cortical atrophy. Three patients with toxoplasmosis had
cerebral pathology, in two of them with ring enhancement while the third
had an ill-defined nonspecific lesion with slight heterogeneous
enhancement without ring formation. Two patients with multifocal
leucoencephalopathy and non-Hodgkin's lymphoma, respectively, presented
non-enhancing, low attenuating lesions at CT.
MH - Acquired Immunodeficiency Syndrome/*RADIOGRAPHY ; Adult ; Brain Diseases/
*RADIOGRAPHY ; Human ; Male ; Middle Age ; *Tomography, X-Ray Computed ;
Toxoplasmosis/RADIOGRAPHY
SO - Acta Radiol [Diagn] (Stockh) 1986 Jul-Aug;27(4):385-7
11
UI - 87037100
AU - Gartner S ; Markovits P ; Markovitz DM ; Betts RF ; Popovic M
TI - Virus isolation from and identification of HTLV-III/LAV-producing cells
in brain tissue from a patient with AIDS.
AB - Primary cultures from a brain biopsy specimen of a human T-cell
lymphotropic virus type III/lymphadenopathy-associated virus
(HTLV-III/LAV) seropositive patient with progressive dementia contained
small numbers of monocytoid cells and showed reverse transcriptase
activity that persisted for as long as 100 days. Electron microscopy of
these cells revealed the presence of HTLV-III/LAV virions. Subcultured
cells removed from primary cultures by trypsinization were nonspecific
esterase negative and did not express virus or show evidence of
HTLV-III/LAV proviral sequences, while those remaining in the original
flasks were nonspecific esterase positive and continued to produce virus.
Virus from primary cultures was transmitted to peripheral blood-derived
monocyte-macrophages and T cells. Virus production in T-cell cultures was
transient while the monocyte-macrophages, like the primary cultures,
produced virus for at least 120 days. Infection of several brain-derived
cells with this and another HTLV-III/LAV isolate failed to demonstrate
virus replication. These results indicate that the HTLV-III/LAV-infected
cells recovered from the brain of this patient are cells of the
mononuclear phagocyte series.
MH - Acquired Immunodeficiency Syndrome/*MICROBIOLOGY/PATHOLOGY ; Brain/
*MICROBIOLOGY/PATHOLOGY ; Case Report ; Dementia/MICROBIOLOGY ;
Encephalitis/*MICROBIOLOGY/PATHOLOGY ; Human ; HTLV-III/*ISOLATION &
PURIFICATION/PHYSIOLOGY ; Macrophages/MICROBIOLOGY ; Male ; Middle Age ;
Monocytes/MICROBIOLOGY ; Nucleic Acid Hybridization ; T Lymphocytes/
MICROBIOLOGY ; Virus Cultivation ; Virus Replication
SO - JAMA 1986 Nov 7;256(17):2365-71
12
UI - 87037099
AU - Stoler MH ; Eskin TA ; Benn S ; Angerer RC ; Angerer LM
TI - Human T-cell lymphotropic virus type III infection of the central nervous
system. A preliminary in situ analysis.
AB - Patients with the acquired immunodeficiency syndrome (AIDS) are subject
to a spectrum of central nervous system (CNS) disorders. Recent evidence
implicates the human T-cell lymphotropic virus type III (HTLV-III) in the
pathogenesis of some of these illnesses, although, the cells infected by
the virus have yet to be identified. Using in situ hybridization, we
examined brain tissue from two patients with AIDS encephalopathy for the
presence of HTLV-III RNA. In both cases, viral RNA was detected and
concentrated in, though not limited to, the white matter. The CNS cells
most frequently infected included macrophages, pleomorphic microglia, and
multinucleated giant cells. Less frequently, cells morphologically
consistent with astrocytes, oligodendroglia, and rarely neurons were also
infected. The findings strengthen the association of HTLV-III with the
pathogenesis of AIDS encephalopathy. In situ hybridization can be applied
to routinely prepared biopsy tissue in the diagnosis of HTLV-III
infection of the CNS.
MH - Acquired Immunodeficiency Syndrome/*MICROBIOLOGY/PATHOLOGY ; Adult ;
Brain/MICROBIOLOGY/PATHOLOGY ; Case Report ; Encephalitis/*MICROBIOLOGY/
PATHOLOGY ; Human ; HTLV-III/*ISOLATION & PURIFICATION ; Male ; Middle
Age ; Nucleic Acid Hybridization ; RNA, Viral/ANALYSIS ; Support, U.S.
Gov't, P.H.S.
SO - JAMA 1986 Nov 7;256(17):2360-4
13
UI - 87035695
AU - Petito CK ; Cho ES ; Lemann W ; Navia BA ; Price RW
TI - Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy
review.
AB - In the brains and spinal cords of 153 adult patients dying with acquired
immunodeficiency syndrome (AIDS) at New York and Memorial Hospitals a
subacute encephalitis with multinucleated cells was present in 28% of all
patients. This encephalitis was characterized by multinucleated cells
primarily located in the white matter and associated with myelin pallor
and sparse infiltrates of rod cells, macrophages, gemistocytic astrocytes
and lymphocytes. The incidence per 12 month period ranged from 0 to 43%
and significantly increased between 1983-84 (14%) and 1984-85 (43%).
Recent virologic and pathologic studies suggest that this encephalitis
may be caused by direct LAV/HTLV-III infection of the central nervous
system (CNS). Cytomegalovirus encephalomyelitis and toxoplasmosis were
the most common opportunistic infections (26% and 10%, respectively).
Progressive multifocal leukoencephalopathy, herpes simplex ventriculitis,
varicella-zoster leukoencephalitis and fungal infections were infrequent
(less than 3% each). A nonspecific encephalitis with microglial nodules
and with mild white matter changes occurred in 17%, vacuolar myelopathy
in 29% and CNS lymphoma in 6%. Less than 20% of patients had either
normal brains or terminal metabolic encephalopathies. This survey shows
that neuropathologic complications of AIDS are frequent. Infections are
the most common complication and are caused by probable LAV/HTLV-III
infection, or by opportunistic organisms.
MH - Acquired Immunodeficiency Syndrome/*PATHOLOGY ; Central Nervous System
Diseases/PATHOLOGY ; Central Nervous System/*PATHOLOGY ; Encephalitis/
PATHOLOGY ; Herpesvirus Infections/PATHOLOGY ; Human ; Spinal Cord
Diseases/PATHOLOGY ; Toxoplasmosis/PATHOLOGY
SO - J Neuropathol Exp Neurol 1986 Nov;45(6):635-46
14
UI - 87035180
AU - McArthur JH ; McArthur JC
TI - Neurological manifestations of acquired immunodeficiency syndrome.
AB - This article provides an overview of the range of neurological
manifestations that have been described in association with human
immunodeficiency virus (HIV) infection. The transmission of acquired
immunodeficiency syndrome (AIDS) and the precautions personnel must take
when having contact with patients with AIDS are briefly reviewed. The
nursing approach to the neurologically impaired victim of HIV infection
is discussed.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Central Nervous
System Diseases/*ETIOLOGY/NURSING ; Cryptococcosis/ETIOLOGY ; Dementia/
ETIOLOGY ; Female ; Herpesvirus Infections/ETIOLOGY ; Human ;
Hyperesthesia/ETIOLOGY ; HTLV Infections/COMPLICATIONS ;
Leukoencephalopathy, Progressive Multifocal/ETIOLOGY ; Male ; Meningitis,
Viral/ETIOLOGY ; Nervous System Neoplasms/ETIOLOGY ; Spinal Cord Diseases/
ETIOLOGY ; Toxoplasmosis/ETIOLOGY
SO - J Neurosci Nurs 1986 Oct;18(5):242-9
15
UI - 87032187
AU - Sethi KK ; N:aher H
TI - Elevated titers of cell-free interleukin-2 receptor in serum and
cerebrospinal fluid specimens of patients with acquired immunodeficiency
syndrome.
AB - A sensitive monoclonal antibody based ELISA was used to detect cell-free
interleukin-2 receptor (IL-2R) in the body fluids of patients with
acquired immune deficiency syndrome (AIDS), a variety of other disease
conditions and a control group of apparently healthy (heterosexual and
homosexual) males. Two of the 25 control donors showed low titers (1:8)
of IL-2 receptor in the serum samples; the cerebrospinal fluid (CSF)
specimens from these individuals proved negative. However, serum and CSF
specimens from all the 9 patients with AIDS showed significantly elevated
titers (range 1:128 to 1:4096) of IL-2 receptor. The presence of moderate
titers (range 1:128 to 1:512) of circulating IL-2 receptor could also be
detected in all of the 4 patients with acute lymphocytic leukemia. IL-2
receptor was detectable in the CSF and/or serum specimens from 3 of 3
patients with lung cancer, 3 of 4 patients with acute hepatitis B
infection, and 2 of 3 patients with multiple sclerosis. IL-2 receptor
could not be detected in the serum or CSF specimens originating from
patients with legionellosis (3/3), asthma (3/3), or those with
non-pulmonary febrile bacterial infections (4/4). It is concluded that
soluble IL-2 receptor may be found in serum or CSF specimens from
patients with certain (but not all) disease conditions including AIDS.
The conspicuously elevated titers of cell-free IL-2R in the body fluids
of patients with AIDS may contribute to the drastic impairment of the
immune system regulation observed in such patients.
MH - Acquired Immunodeficiency Syndrome/BLOOD/CEREBROSPINAL FLUID/*IMMUNOLOGY
; Antibodies, Viral/ANALYSIS ; Comparative Study ; Enzyme-Linked
Immunosorbent Assay ; Human ; HTLV-III/IMMUNOLOGY ; Interleukin 2/
IMMUNOLOGY ; Leukemia, Lymphoblastic/BLOOD/CEREBROSPINAL FLUID/IMMUNOLOGY
; Multiple Sclerosis/BLOOD/CEREBROSPINAL FLUID/IMMUNOLOGY ; Receptors,
Immunologic/*BIOSYNTHESIS
SO - Immunol Lett 1986 Oct;13(4):179-84
16
UI - 87025054
AU - Dickson DW
TI - Multinucleated giant cells in acquired immunodeficiency syndrome
encephalopathy. Origin from endogenous microglia?
AB - Multinucleated giant cells that are characteristic of the
encephalomyelopathy of acquired immunodeficiency syndrome are stained by
a lectin histochemical method. The particular lectin used, Ricinus
communis agglutinin I, has been shown to bind to endogenous microglial
cells in human brain, as well as to endothelial cells of blood vessels.
These results suggest that multinucleated giant cells in the brain of
patients with acquired immunodeficiency syndrome may be derived from
endogenous microglia.
MH - Acquired Immunodeficiency Syndrome/*PATHOLOGY ; Adult ; Astrocytes/
PATHOLOGY ; Brain Diseases/*PATHOLOGY ; Cell Membrane/PATHOLOGY ; Cell
Nucleus/PATHOLOGY ; Child ; Cytoplasm/PATHOLOGY ; Endothelium/PATHOLOGY ;
Histocytochemistry ; Human ; Immunoenzyme Technics ; Lectins
SO - Arch Pathol Lab Med 1986 Oct;110(10):967-8
17
UI - 87024226
AU - Zaidman GW
TI - Neurosyphilis and retrobulbar neuritis in a patient with AIDS.
AB - A 33-year-old homosexual patient with acquired immune deficiency syndrome
(AIDS) developed sudden unilateral loss of vision. Slit-lamp and
funduscopic examination of the affected eye was completely within normal
limits. The patient, however, had a Marcus Gunn pupil, decreased color
vision, and a large central scotoma on visual field examination. This was
consistent with retrobulbar optic neuritis. Laboratory investigation
revealed a highly positive serum and cerebrospinal fluid venereal disease
reaction level (VDRL). A diagnosis of neurosyphilis was made, and the
patient was treated with ten days of intravenous penicillin therapy.
Ophthalmologists should be aware that many patients with AIDS have also
been exposed to syphilis. Regardless of their clinical presentation, all
AIDS patients should be examined and tested for syphilis and treated as
is necessary.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Case Report ;
Fluorescein Angiography ; Human ; Male ; Neurosyphilis/*COMPLICATIONS ;
Optic Neuritis/*COMPLICATIONS/PATHOLOGY/PHYSIOPATHOLOGY ; Visual Fields
SO - Ann Ophthalmol 1986 Sep;18(9):260-1
18
UI - 87022686
AU - Levy RM ; Rosenbloom S ; Perrett LV
TI - Neuroradiologic findings in AIDS: a review of 200 cases.
AB - The radiologic studies of 200 consecutive AIDS patients with neurologic
symptoms were evaluated to determine their diagnostic specificity and
prognostic value. Of 81 patients with initially normal CT scans, four
(5%) later developed progressive neurologic illness. Of 75 patients with
CT evidence of diffuse cerebral atrophy, 12 (16%) later developed CT
abnormalities or had postmortem CNS disease. CT scans showed mass lesions
initially in 44 patients and later in an additional seven patients.
Although toxoplasma gondii infection was the most frequent cause of these
lesions, the CT characteristics of cerebral toxoplasmosis are too
nonspecific to warrant diagnosis without biopsy. Preliminary evidence
suggests that MRI may be more sensitive than CT in detecting intracranial
disease in patients with AIDS.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY ; Adult ;
Brain Abscess/ETIOLOGY/*RADIOGRAPHY ; Brain Neoplasms/ETIOLOGY/
*RADIOGRAPHY ; Central Nervous System Diseases/RADIOGRAPHY ; Human ;
Lymphoma/ETIOLOGY/*RADIOGRAPHY ; Male ; Middle Age ; Support, Non-U.S.
Gov't ; Toxoplasmosis/ETIOLOGY/*RADIOGRAPHY
SO - AJR 1986 Nov;147(5):977-83
19
UI - 87016079
AU - Epstein LG ; Sharer LR ; Oleske JM ; Connor EM ; Goudsmit J ; Bagdon L ;
Robert-Guroff M ; Koenigsberger MR
TI - Neurologic manifestations of human immunodeficiency virus infection in
children.
AB - This report describes the neurologic manifestations of 36 children with
human immunodeficiency virus (HIV) infection. In this cohort, in 16 of 21
children with acquired immunodeficiency syndrome (AIDS), three of 12
children with AIDS-related complex, and one of three asymptomatic
seropositive children, a progressive encephalopathy developed. Neurologic
signs were often detected early but tended to worsen coincident with
progression of the immunodeficiency. The presence of progressive
encephalopathy correlated with the absence of serum neutralizing
antibodies to HIV and with a poor, usually fatal, outcome. The incubation
period from initial HIV infection in the perinatal period to the onset of
progressive encephalopathy varied from 2 months to 5 years.
Intrablood-brain barrier synthesis of HIV-specific antibodies was
demonstrated in eight of 14 children with AIDS and AIDS-related complex,
indicating active brain infection with HIV. In three cases this was
unassociated with progressive neurologic signs. Unique neuropathologic
findings in children who died with HIV infection further suggest that the
progressive encephalopathy is the result of primary and persistent
infection of the brain with this retrovirus. These findings broaden the
spectrum of HIV infection in children and have important implications for
the development of antiviral therapy.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY ;
Antibodies, Viral/ANALYSIS ; Brain Diseases/*ETIOLOGY/PATHOLOGY/
RADIOGRAPHY ; Cerebrospinal Fluid/ANALYSIS ; Child Development Disorders/
ETIOLOGY ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Human
; Infant ; Male ; Prognosis ; Support, U.S. Gov't, P.H.S. ; Tomography,
X-Ray Computed
SO - Pediatrics 1986 Oct;78(4):678-87
20
UI - 87000017
AU - Gould IA ; Belok LC ; Handwerger S
TI - Listeria monocytogenes: a rare cause of opportunistic infection in the
acquired immunodeficiency syndrome (AIDS) and a new cause of meningitis
in AIDS. A case report.
AB - A forty-two year-old male homosexual with the acquired immunodeficiency
syndrome (AIDS) developed Listeria monocytogenes septicemia and
meningitis. The gastrointestinal tract was the likely portal of entry.
The patient was treated with intravenous ampicillin with complete and
permanent resolution of his listerial infection. Although L.
monocytogenes infection has been reported as an uncommon complications of
AIDS, we are unaware of Listeria meningitis being previously reported in
an AIDS patient. It is hoped that this case report will alert health care
workers to the possibility of Listeria infection in AIDS patients,
particularly since this infection responds well to readily-available
antibiotic therapy. The microbiology, epidemiology, clinical, and
neurologic aspects of listerial infection and general aspects of the
acquired immunodeficiency syndrome are discussed.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Case Report ;
Homosexuality ; Human ; Male ; Meningitis, Listeria/*COMPLICATIONS ;
Middle Age ; Septicemia/COMPLICATIONS
SO - AIDS Res 1986 Summer;2(3):231-4
21
UI - 86294297
AU - Rosenberg NL ; Hochberg FH ; Miller G ; Kleinschmidt-DeMasters BK
TI - Primary central nervous system lymphoma related to Epstein-Barr virus in
a patient with acquired immune deficiency syndrome.
AB - The study of a patient suggested a relationship between Epstein-Barr
virus infection and primary lymphoma of the central nervous system in the
acquired immune deficiency syndrome. Deoxyribonucleic acid preparations
from tumor tissue contained 30 to 100 copies of Epstein-Barr virus genome
per cell when hybridized with a probe consisting of the Bam-HI K fragment
of Epstein-Barr virus strain FF41. This hybridization study suggests that
induction of this patient's central nervous system lymphoma was related
to Epstein-Barr virus infection.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Brain Neoplasms/
ANALYSIS/*COMPLICATIONS ; Case Report ; DNA, Viral/ANALYSIS ;
Epstein-Barr Virus ; Human ; Lymphoma, Non-Hodgkin's/ANALYSIS/
*COMPLICATIONS ; Male ; Middle Age ; *Occipital Lobe ; Tumor Virus
Infections/*COMPLICATIONS
SO - Ann Neurol 1986 Jul;20(1):98-102
22
UI - 86319782
AU - Lee YY ; Bruner JM ; Van Tassel P ; Libshitz HI
TI - Primary central nervous system lymphoma: CT and pathologic correlation.
AB - CT findings of 15 patients with histologically proven primary central
nervous system (CNS) lymphoma were reviewed with pathologic correlation
in order to evaluate variable CT patterns. There were a total of 32
lesions. Of the 15 patients studied, seven had acquired immunodeficiency
syndrome (AIDS), all diagnosed within the past 3 years. The CT
observations of eight non-AIDS patients were consistent with findings
reported previously. Most of the lymphomatous lesions were either hyper-
or isodense, round or oval masses with homogeneous contrast enhancement
and variable surrounding edema. Pathologic examination showed tightly
packed preserved lymphoma cells without necrosis. In AIDS patients, rim
or ring enhancement of lymphoma, indistinguishable from brain abscess,
was frequently seen. Histologic examination consistently showed extensive
tumor necrosis with preservation of viable tumor cells at the periphery.
A third and infrequent CT pattern was multiple infiltrative nonnodular
solid enhancement with extensive edema. Pathologic correlation showed
infiltrating viable tumor cells without necrosis. The rim- or
ring-enhancing brain lesion seen in AIDS patients can either be an
abscess or a primary lymphoma; proper tissue collection is essential for
correct diagnosis and appropriate treatment.
MH - Acquired Immunodeficiency Syndrome/PATHOLOGY/RADIOGRAPHY ; Adolescence ;
Adult ; Aged ; Brain Neoplasms/PATHOLOGY/*RADIOGRAPHY ; Child ; Female ;
Human ; Lymphoma/PATHOLOGY/*RADIOGRAPHY ; Male ; Middle Age ; Tomography,
X-Ray Computed
SO - AJR 1986 Oct;147(4):747-52
23
UI - 86319066
AU - Bernstein WB ; Scherokman B
TI - Neuroleptic malignant syndrome in a patient with acquired
immunodeficiency syndrome.
AB - A patient with acquired immunodeficiency syndrome treated with
prochlorperazine and droperidol developed neuroleptic malignant syndrome,
characterized by akinetic mutism, resting tremor, cogwheel rigidity, and
elevated serum creatine phosphokinase. An identical syndrome reappeared
with subsequent administration of haloperidol. Neuroleptic malignant
syndrome has not been previously reported in acquired immunodeficiency
syndrome.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PSYCHOLOGY ; Adult ;
Case Report ; Female ; Human ; Neuroleptic Malignant Syndrome/*ETIOLOGY/
PSYCHOLOGY
SO - Acta Neurol Scand 1986 Jun;73(6):636-7
24
UI - 86319059
AU - Singh BM ; Levine S ; Yarrish RL ; Hyland MJ ; Jeanty D ; Wormser GP
TI - Spinal cord syndromes in the acquired immune deficiency syndrome.
AB - Two patients with AIDS developed paraparesis. Neuropathological post
mortem examination in one revealed cytomegalovirus polyradiculopathy, and
in the second, vacuolar myelopathy which occurred in association with
brain lesions resembling Marchiafava-Bignami Syndrome.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ;
Case Report ; Cytomegalic Inclusion Disease/ETIOLOGY/PATHOLOGY ;
Hemoglobinuria, Paroxysmal/ETIOLOGY/PATHOLOGY ; Human ; Male ; Myelin
Sheath/PATHOLOGY ; Spinal Cord Diseases/*ETIOLOGY/PATHOLOGY
SO - Acta Neurol Scand 1986 Jun;73(6):590-8
25
UI - 86306818
AU - Farkash AE ; Maccabee PJ ; Sher JH ; Landesman SH ; Hotson G
TI - CNS toxoplasmosis in acquired immune deficiency syndrome: a
clinical-pathological-radiological review of 12 cases.
AB - From January 1981 to January 1983 acquired immune deficiency syndrome
(AIDS) was diagnosed in 90 patients admitted to Kings County
Hospital-Downstate Medical Center. CNS involvement occurred in 18
patients of whom 12 had toxoplasmosis confirmed by biopsy or necropsy.
Pathological specimens from these 12 patients were notable for a marked
diminution or absence of cellular inflammation. Each patient had elevated
serological studies for toxoplasma. AIDS presented with symptoms
referable to CNS toxoplasma in eight patients. In the remaining four
patients, toxoplasma was found late in the course of the illness. CT
showed either ring enhancing lesions or solid nodules. The course was
uniformly fatal, though patients treated continuously with pyrimethamine
and sulfadiazine survived longer.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Brain/
ULTRASTRUCTURE ; Central Nervous System Diseases/*COMPLICATIONS/DIAGNOSIS/
PATHOLOGY ; Human ; Male ; Microscopy, Electron ; Middle Age ;
Toxoplasmosis/*COMPLICATIONS/DIAGNOSIS/PATHOLOGY
SO - J Neurol Neurosurg Psychiatry 1986 Jul;49(7):744-8
26
UI - 86293841
AU - Wolcott DL
TI - Psychosocial aspects of acquired immune deficiency syndrome and the
primary care physician.
AB - Acquired immune deficiency syndrome is now an epidemic in the United
States. Multiple factors contribute to the high degree of psychosocial
stress experienced by those with HTLV-III infection, regardless of their
current clinical status. Family members, friends, and health care
professionals all often experience significant stresses associated with
HTLV-III infection or AIDS-spectrum illness in the patient. Knowledge
about the psychosocial consequences of cancer, of the unique psychosocial
stresses experienced by individuals with AIDS-spectrum illness, and of
the functional psychiatric syndromes and organic mental disorders common
to AIDS can assist the primary care physician as he cares for individuals
with HTLV-III infection and AIDS-spectrum illness.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/PSYCHOLOGY/*THERAPY ;
Attitude to Death ; Central Nervous System Diseases/ETIOLOGY ;
Communicable Disease Control ; Human ; Meningitis, Aseptic/ETIOLOGY ;
Patient Education ; *Physicians, Family ; *Social Environment ; Social
Isolation ; Social Problems ; *Social Support ; Stress, Psychological
SO - Ann Allergy 1986 Aug;57(2):95-102
27
UI - 86289457
AU - Koenig S ; Gendelman HE ; Orenstein JM ; Dal Canto MC ; Pezeshkpour GH ;
Yungbluth M ; Janotta F ; Aksamit A ; Martin MA ; Fauci AS
TI - Detection of AIDS virus in macrophages in brain tissue from AIDS patients
with encephalopathy.
AB - One of the common neurological complications in patients with the
acquired immune deficiency syndrome (AIDS) is a subacute encephalopathy
with progressive dementia. By using the techniques of cocultivation for
virus isolation, in situ hybridization, immunocytochemistry, and
transmission electron microscopy, the identity of an important cell type
that supports replication of the AIDS retrovirus in brain tissue was
determined in two affected individuals. These cells were mononucleated
and multinucleated macrophages that actively synthesized viral RNA and
produced progeny virions in the brains of the patients. Infected brain
macrophages may serve as a reservoir for virus and as a vehicle for viral
dissemination in the infected host.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*MICROBIOLOGY/PATHOLOGY
; Brain/MICROBIOLOGY/PATHOLOGY ; Brain Diseases/ETIOLOGY/*MICROBIOLOGY/
PATHOLOGY ; Dementia/ETIOLOGY/MICROBIOLOGY ; Demyelinating Diseases/
MICROBIOLOGY/PATHOLOGY ; Encephalitis/MICROBIOLOGY ; Human ; Human T-Cell
Leukemia Virus/ANALYSIS/*ISOLATION & PURIFICATION ; Macrophages/
*MICROBIOLOGY ; Microscopy, Electron ; Nucleic Acid Hybridization ;
Papovaviridae/ISOLATION & PURIFICATION ; RNA, Viral/ANALYSIS
SO - Science 1986 Sep 5;233(4768):1089-93
28
UI - 86266880
AU - Bishburg E ; Sunderam G ; Reichman LB ; Kapila R
TI - Central nervous system tuberculosis with the acquired immunodeficiency
syndrome and its related complex.
AB - Central nervous system tuberculosis occurred in three patients with the
acquired immunodeficiency syndrome (AIDS) and seven patients with
AIDS-related complex who were evaluated for 48 months. Nine patients were
intravenous drug abusers and one was Haitian. Five patients had
cerebral-ring-enhancing lesions and three had hypodense areas. The
clinical spectrum included meningitis in two patients, multiple cerebral
abscesses in one, and tuberculomas in four. All Mycobacterium
tuberculosis isolates were sensitive to standard antituberculous drugs.
All patients received treatment with isoniazid, rifampin, and
pyrazinamide; six patients also received streptomycin. Three patients
with AIDS died of opportunistic infection preceded by central nervous
system tuberculosis. Among the patients with the AIDS-related complex,
three improved with treatment, three were lost to follow-up, and one
died. Tuberculosis should be considered in the differential diagnosis of
central nervous system mass lesions in intravenous drug abusers with AIDS
or AIDS-related complex. Because patients with tuberculosis can be cured,
biopsy of accessible brain mass lesions should be mandatory. Preventive
therapy may be indicated in drug abusers without disease.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Brain Abscess/
ETIOLOGY/RADIOGRAPHY ; Case Report ; Central Nervous System Diseases/
*ETIOLOGY ; Female ; Human ; Male ; Tomography, X-Ray Computed ;
Tuberculoma/ETIOLOGY/RADIOGRAPHY ; Tuberculosis/*ETIOLOGY/RADIOGRAPHY ;
Tuberculosis, Meningeal/ETIOLOGY
SO - Ann Intern Med 1986 Aug;105(2):210-3
29
UI - 86257042
AU - Sarwar M ; Falkoff G ; Naseem M
TI - Radiologic techniques in the diagnosis of CNS infections.
AB - The radiologic diagnosis of CNS infections remains a challenge. CT scan
findings, though admittedly nonspecific to a large extent, assume great
diagnostic significance when considered in conjunction with clinical and
laboratory findings. MRI is expected to show abnormalities in the earlier
stages of these infections.
MH - Acquired Immunodeficiency Syndrome/RADIOGRAPHY ; Arteritis/RADIOGRAPHY ;
Brain Abscess/RADIOGRAPHY ; Central Nervous System Diseases/DIAGNOSIS/
*RADIOGRAPHY ; Cerebral Angiography ; Cerebral Ventricles ;
Cerebrovascular Disorders/RADIOGRAPHY ; Cysticercosis/RADIOGRAPHY ;
Encephalitis/ETIOLOGY/RADIOGRAPHY ; Herpes Simplex ; Human ; Infection/
DIAGNOSIS/*RADIOGRAPHY ; Jakob-Creutzfeldt Syndrome/RADIOGRAPHY ;
Leukoencephalopathy, Progressive Multifocal/RADIOGRAPHY ; Lymphoma/
RADIOGRAPHY ; Meningitis/RADIOGRAPHY ; Mycoses/RADIOGRAPHY ; Nuclear
Magnetic Resonance ; Subacute Sclerosing Panencephalitis/RADIOGRAPHY ;
Subdural Effusion/RADIOGRAPHY ; Subdural Empyema/RADIOGRAPHY ;
*Tomography, X-Ray Computed ; Toxoplasmosis/RADIOGRAPHY ; Tuberculosis,
Meningeal/RADIOGRAPHY ; Ultrasonic Diagnosis
SO - Neurol Clin 1986 Feb;4(1):41-68
30
UI - 86257039
AU - Price RW ; Navia BA ; Cho ES
TI - AIDS encephalopathy.
AB - It is now recognized that AIDS is frequently complicated by a progressive
encephalopathy characterized by dementia and motor dysfunction. This
article reviews the early and late clinical features of this disorder and
examines current evidence that it is due to direct brain infection by the
retrovirus that causes AIDS.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/ETIOLOGY/OCCURRENCE ;
America ; Brain Diseases/*COMPLICATIONS/PATHOLOGY ; Child ; Child,
Preschool ; Dementia/COMPLICATIONS/DIAGNOSIS/OCCURRENCE/PSYCHOLOGY ;
Europe ; Human ; Male ; Support, Non-U.S. Gov't
SO - Neurol Clin 1986 Feb;4(1):285-301
31
UI - 86257034
AU - Bia FJ ; Barry M
TI - Parasitic infections of the central nervous system.
AB - The authors give a comprehensive review of the epidemiology, clinical
presentations, diagnosis and current therapy of parasitic infections with
CNS manifestations in both the normal and immunocompromised host. These
include toxoplasmosis, malaria, amebiasis, neurocystcersosis, hydatid
disease, and trichinosis. Additional sections cover disseminated
strongyloidiasis, eosinophilic meningitis, visceral and ocular larva
migrans, schistosomiasis, and cerebral paragonimiasis. Emphasis is on the
neurologic complications of these diseases and their presentations in
populations at increased risk for acquiring or reactivating these
infections.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Amebiasis ;
Amebicides/THERAPEUTIC USE ; Antimalarials/THERAPEUTIC USE ; Brain
Abscess/DIAGNOSIS/DRUG THERAPY/ETIOLOGY ; Central Nervous System Diseases/
COMPLICATIONS/*DIAGNOSIS/DRUG THERAPY/PARASITOLOGY ; Cysticercosis/
DIAGNOSIS/DRUG THERAPY/PATHOLOGY/PARASITOLOGY ; Echinococcosis/DIAGNOSIS/
DRUG THERAPY/PARASITOLOGY ; Entamoebiasis/COMPLICATIONS ; Eosinophilia/
COMPLICATIONS/DIAGNOSIS/DRUG THERAPY/PARASITOLOGY ; Human ; Malaria/
COMPLICATIONS/DIAGNOSIS/DRUG THERAPY/ETIOLOGY ; Male ; Meningitis/
COMPLICATIONS/DIAGNOSIS/DRUG THERAPY/PARASITOLOGY ; Meningoencephalitis/
DIAGNOSIS/DRUG THERAPY/ETIOLOGY ; Neoplasms/COMPLICATIONS ;
Paragonimiasis/DIAGNOSIS/DRUG THERAPY/ETIOLOGY ; Parasitic Diseases/
COMPLICATIONS/*DIAGNOSIS/DRUG THERAPY/PARASITOLOGY ; Review ;
Schistosomiasis/CLASSIFICATION/DIAGNOSIS/DRUG THERAPY/PARASITOLOGY ;
Strongyloidiasis/COMPLICATIONS/DIAGNOSIS/PARASITOLOGY ; Support, U.S.
Gov't, Non-P.H.S. ; Toxoplasmosis/COMPLICATIONS/PARASITOLOGY ;
Trichinosis/DIAGNOSIS/DRUG THERAPY/MORTALITY/PREVENTION & CONTROL
SO - Neurol Clin 1986 Feb;4(1):171-206
32
UI - 86257033
AU - Lyons RW ; Andriole VT
TI - Fungal infections of the CNS.
AB - Most CNS fungal infections can be divided into those that occur in normal
hosts and those that occur in the immunosuppressed host. Cryptococcal
infection, however, is common in both groups. The usual clinical
presentation of a CNS fungal infection is chronic headache and mental
status change. The CSF shows a lymphocytic meningitis with low sugar and
high protein. Amphotericin B remains the drug of choice for most CNS
fungal infections.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Antifungal Agents/
THERAPEUTIC USE ; Blastomycosis/COMPLICATIONS/DIAGNOSIS ; Central Nervous
System Diseases/COMPLICATIONS/*MICROBIOLOGY/PATHOLOGY/THERAPY ;
Cerebrospinal Fluid/ANALYSIS/CYTOLOGY ; Coccidioidomycosis/COMPLICATIONS/
DIAGNOSIS ; Cryptococcosis/COMPLICATIONS/MICROBIOLOGY ; Diabetes Mellitus/
COMPLICATIONS ; Histoplasmosis/COMPLICATIONS/DIAGNOSIS ; Human ; Immune
Tolerance ; Maduromycosis/COMPLICATIONS ; Mucormycosis/COMPLICATIONS/
DIAGNOSIS/PATHOLOGY/TRANSMISSION ; Mycoses/COMPLICATIONS/*MICROBIOLOGY/
PATHOLOGY/THERAPY ; Review
SO - Neurol Clin 1986 Feb;4(1):159-70
33
UI - 86256022
AU - Goudsmit J ; de Wolf F ; Paul DA ; Epstein LG ; Lange JM ; Krone WJ ;
Speelman H ; Wolters EC ; Van der Noordaa J ; Oleske JM ; et al
TI - Expression of human immunodeficiency virus antigen (HIV-Ag) in serum and
cerebrospinal fluid during acute and chronic infection.
AB - Human immunodeficiency virus antigen (HIV-Ag) was detected in the serum
of most adult (13/16) and paediatric (6/6) AIDS patients and rarely in
the serum of symptomless seropositive controls (1/13). It was present in
the cerebrospinal fluid (CSF) of all 5 children and most (5/9) adults
with AIDS-related encephalopathy, but not in the CSF of 13 symptomless
seropositive controls, of whom 8 had antibody in the CSF. A longitudinal
study of 1 of the controls with antibody in the CSF showed that HIV-Ag in
CSF was present transiently before the occurrence of antibody in the CSF.
In serial samples of serum from 35 men who seroconverted HIV-Ag was
detected in 11 persons--in 5 before seroconversion and in 6 after. 3 of
the 6 who became antigenaemic after seroconversion remained so for the
rest of the follow-up. AIDS was diagnosed in 1 patient, 3 months after
HIV-Ag was first detected in serum and 6 months after seroconversion. The
findings suggest that HIV-Ag appears early and transiently in primary HIV
infection. Antibody production follows, after which HIV-Ag may disappear.
Its persistence or reappearance seems to correlate with clinical,
immunological, and neurological deterioration.
MH - Acquired Immunodeficiency Syndrome/DIAGNOSIS/*IMMUNOLOGY ; Acute Disease
; Adult ; Antibodies, Viral/ANALYSIS ; Antigens, Viral/*ANALYSIS/
CEREBROSPINAL FLUID ; Brain Diseases/IMMUNOLOGY ; Child ; Child,
Preschool ; Chronic Disease ; Female ; Homosexuality ; Human ; Human
T-Cell Leukemia Virus/*IMMUNOLOGY ; Immunoassay ; Infant ; Male ; Middle
Age ; Prospective Studies ; Risk ; Support, Non-U.S. Gov't ; Support,
U.S. Gov't, P.H.S. ; Time Factors
SO - Lancet 1986 Jul 26;2(8500):177-80
34
UI - 86254284
AU - Raedler A ; Bredow G ; Kirch W ; Thiele HG ; Greten H
TI - In vivo activated peripheral T cells in autoimmune disease.
AB - Starting from the observation, if that in patients suffering from
inflammatory bowel diseases elevated numbers of activated peripheral
immunocytes can be detected in correlation to the activity of the
disease, subpopulations of lymphocytes in immune-mediated disorders were
analyzed for the expression of activation associated antigens. It was
found that in patients with immunovasculitis, sarcoidosis, M. Beh:cet,
multiple sclerosis, antibody-mediated hemophilia, SLE,--but not in those
with scleroderma--, increased numbers of activated immunocytes could be
detected during acute exacerbation, whereas, in remission, the population
of activated immunocytes was in the upper normal range. Analyses of
phenotypes revealed that the majority of activated immunocytes are T
cells. However, a variable minority of cells bear B cell associated
determinants. As is the case in total peripheral T cells, the T4 to T8
ratio was in a normal range. Only in Beh:cet disease and immunovasculitis
was the ratio of activated T4 positive to activated T8 positive
lymphocytes found to be decreased. In contrast to T cells in patients
with inflammatory bowel disease, the majority of activated T cells in the
autoimmune disorders under study does not express Fc alpha-receptors. In
Beh:cet disease and immunovasculitis moreover, the incidence of activated
Leu 7 positive (= natural killer) cells is low compared to T cells from
patients with Crohn's disease or ulcerative colitis. These experiments
lead to the conclusion that the assessment of activated immunocytes may
serve as a parameter in the evaluation of the clinical activity of
autoimmune diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
MH - Acquired Immunodeficiency Syndrome/BLOOD ; Adult ; Aged ; Autoimmune
Diseases/*BLOOD/FAMILIAL & GENETIC ; Behcet's Syndrome/BLOOD ;
Comparative Study ; Helper Cells/IMMUNOLOGY ; Human ; Killer Cells,
Natural/IMMUNOLOGY ; Lupus Erythematosus, Systemic/BLOOD ; Lymphocyte
Transformation ; Middle Age ; Multiple Sclerosis/BLOOD ; Phenotype ;
Receptors, Fc/PHYSIOLOGY ; Sarcoidosis/BLOOD ; Support, Non-U.S. Gov't ;
T Lymphocytes/*IMMUNOLOGY ; T Lymphocytes, Cytotoxic/IMMUNOLOGY ;
Vasculitis/BLOOD/IMMUNOLOGY
SO - J Clin Lab Immunol 1986 Apr;19(4):181-6
35
UI - 86249793
AU - Detmer WM ; Lu FG
TI - Neuropsychiatric complications of AIDS: a literature review.
AB - Acquired immune deficiency syndrome (AIDS) has become a major public
health problem with over 12,000 cases and 6,000 deaths reported to date.
Although there has been an explosion of knowledge in the virology,
immunology and pathology of AIDS, relatively little has been written on
the neuropsychiatric aspects. This report reviews the existing literature
on the neuropsychiatric complications of AIDS. As many as 40 percent of
patients with AIDS have neurologic complications at some point in their
illness. These complications include either focal deficits attributable
to opportunistic organisms infecting the CNS or diffuse encephalopathy
caused by viral infection or lymphoma infiltration. Psychiatric
complications include major depression, adjustment disorder with
depressed mood, and organic brain syndrome with affective, delusional or
demented features. Inpatient and consulting psychiatrists must be alert
to these complications of AIDS so as to make accurate diagnoses and
deliver appropriate therapy. Further studies, integrating both
psychiatric and neurologic perspectives, are needed to better elucidate
the neuropsychiatric complications of AIDS and help plan appropriate
therapeutic interventions.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adjustment Disorders/
ETIOLOGY ; Brain Diseases/*ETIOLOGY ; Brain Neoplasms/ETIOLOGY ;
Cerebrovascular Disorders/ETIOLOGY ; Cryptococcosis/ETIOLOGY ; Depressive
Disorder/ETIOLOGY ; Encephalitis/ETIOLOGY ; Human ; Lymphoma/ETIOLOGY ;
Mental Disorders/*ETIOLOGY ; Organic Mental Disorders/ETIOLOGY ; Review ;
Toxoplasmosis/ETIOLOGY
SO - Int J Psychiatry Med 1986-87;16(1):21-9
36
UI - 86238345
AU - Lindboe CF ; Fr:land SS ; Wefring KW ; Linnestad PJ ; B:hmer T ; Foerster
A ; L:ken AC
TI - Autopsy findings in three family members with a presumably acquired
immunodeficiency syndrome of unknown etiology.
AB - This paper presents clinical, immunological and post-mortem findings in
three family members (husband, wife and daughter) who all died in 1976
after having had chronic and recurrent opportunistic infections for many
years. In all of them a progressive, presumably acquired T-lymphocyte
defect associated with B-lymphocyte dysfunction had been diagnosed
several years before death. The clinical and immunological findings are
compatible with those seen in acquired immunodeficiency syndrome (AIDS)
caused by HTLV-III/LAV infection, but examinations of stored blood
samples from the three patients were negative with regard to the presence
of HTLV-III/LAV antibodies. This immunodeficiency may therefore have been
caused by an infectious agent of unknown nature. The most remarkable
finding on post-mortem examination was the presence of a granulomatous
encephalomyelitis with multinucleated giant cells in the husband and his
wife. In addition, the wife's CNS revealed scattered microglial nodules.
No infectious agents could be demonstrated, and the etiology of this
peculiar CNS affection therefore remains obscure.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/FAMILIAL & GENETIC/
*PATHOLOGY ; Autopsy ; B Lymphocytes/IMMUNOLOGY ; Candidiasis/
COMPLICATIONS ; Cerebral Cortex/PATHOLOGY ; Encephalomyelitis/PATHOLOGY ;
Human ; Pulmonary Alveoli/PATHOLOGY ; Spinal Cord/PATHOLOGY ; T
Lymphocytes/IMMUNOLOGY
SO - Acta Pathol Microbiol Immunol Scand [A] 1986 Mar;94(2):117-23
37
UI - 86231462
AU - Eidelberg D ; Sotrel A ; Vogel H ; Walker P ; Kleefield J ; Crumpacker CS
3d
TI - Progressive polyradiculopathy in acquired immune deficiency syndrome.
AB - We studied three patients with acquired immune deficiency syndrome (AIDS)
and progressive polyradiculopathy. Postmortem examination of one patient
disclosed extensive necrosis, inflammatory infiltrates, and focal
vasculitis of spinal roots. Typical cytomegaloviral (CMV), intranuclear,
and intracytoplasmic inclusions were noted within enlarged endoneurial
and endothelial cells. Progressive polyradiculopathy is an unusual
complication of AIDS; CMV may be the causative agent in certain cases.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Case Report ;
Cauda Equina ; Cytomegalic Inclusion Disease/COMPLICATIONS ; Human ;
Lumbar Vertebrae ; Male ; Polyradiculitis/*ETIOLOGY/PATHOLOGY/RADIOGRAPHY
; Sacrum ; Spinal Nerve Roots/PATHOLOGY/RADIOGRAPHY ; Tomography, X-Ray
Computed
SO - Neurology 1986 Jul;36(7):912-6
38
UI - 86226623
AU - Shih WJ ; Domstad PA ; DeLand FH
TI - Opportunistic intracranial infection in AIDS detection by technetium-99m
DTPA brain scintigraphy.
AB - Radionuclide brain scintigraphy and computed tomography (CT) demonstrated
cerebral lesions in two patients with acquired immunodeficiency disease
syndrome (AIDS) complicated by opportunistic infection of the brain. In
the detection of these cerebral lesions, [99mTc]DTPA radionuclide
scintigraphy was as reliable as CT. Since malignant lymphoma involving
the brain has been seen with increasing frequency in patients with AIDS,
the positive brain scan alone is nonspecific and should be correlated
appropriately with the clinical setting.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/RADIOGRAPHY/
*RADIONUCLIDE IMAGING ; Adult ; Bacterial Infections/RADIONUCLIDE IMAGING
; Brain/RADIOGRAPHY/*RADIONUCLIDE IMAGING ; Case Report ; Encephalitis/
*RADIONUCLIDE IMAGING ; Human ; Male ; Meningitis/*RADIONUCLIDE IMAGING ;
Middle Age ; Tomography, X-Ray Computed ; Virus Diseases/RADIONUCLIDE
IMAGING
SO - J Nucl Med 1986 Apr;27(4):498-501
39
UI - 86224951
AU - Smith JP
TI - Nursing and health care in the twentieth century: myth, reality and
dichotomy.
AB - In this Fourth Ruth Langton Memorial Lecture, the author highlights some
of the major health problems in children, mentally and physically
handicapped people, and in the growing numbers of elderly people in
society. Nurses' roles are discussed. He identifies many major areas of
concern and points out that many of the afflictions affecting people
throughout the world, such as infectious diseases, blindness and
malnutrition, could so easily be prevented. The author also focuses on
the diseases caused by unhealthy lifestyles, in particular heart disease,
cancers, drug addiction and obesity. He argues that a redirection of
resources spent on arms and defense could do much to alleviate disease
and suffering throughout the world. He also questions the present
effectiveness of nursing education programmes and community care
programmes. The paper concludes with a challenge to all nurses to explode
the myth that society is becoming healthier, to face the reality of the
urgent need for more primary health care and health education programmes,
and to heal the dichotomy between present nursing and health care
provision and the actual health needs of society.
MH - Acquired Immunodeficiency Syndrome/NURSING ; Adult ; Aged ; Alzheimer's
Disease/NURSING ; Child ; Great Britain ; Handicapped ; *Health ; Health
Resources ; *Health Status ; Human ; Life Style ; Mental Disorders/
NURSING ; Mental Retardation/NURSING ; Middle Age ; Nursing/*TRENDS ;
Role ; Technology
SO - J Adv Nurs 1986 Mar;11(2):127-32
40
UI - 86214444
AU - Gal AA ; Koss MN ; Hawkins J ; Evans S ; Einstein H
TI - The pathology of pulmonary cryptococcal infections in the acquired
immunodeficiency syndrome.
AB - Specimens from premortem pulmonary cytology, transbronchial biopsy, and
autopsy were studied in 11 patients with acquired immunodeficiency
syndrome who developed pulmonary cryptococcal disease. Nine of 11
patients had culture-proved cryptococcal meningitis. Extremely low T-cell
helper/suppressor ratios (mean, 0.12) were observed in seven of 11
patients. In six of eight patients, transbronchial biopsy specimens
showed a characteristic interstitial pattern with yeasts in the alveolar
septae, minimal cellular inflammation, and no well-formed granulomas. On
cytologic examination, organisms were present in seven (100%) of seven
cell blocks and five (83%) of six smears prepared from the
bronchoalveolar lavage, and in five (63%) of eight bronchial brushings.
Small, poorly encapsulated yeast forms were sometimes present, requiring
mucicarmine and acid mucopolysaccharide stains for confirmation of the
diagnosis of pulmonary cryptococcosis. Overall, bronchoscopy yielded a
diagnosis in seven of eight patients. At autopsy, two of five patients
demonstrated an interstitial pattern of infection in all lobes of the
lung with marked pleural thickening and giant-cell formation; two other
patients showed mixed interstitial and intra-alveolar cryptococcal
infiltrates. Nodal and disseminated infection were present in four
patients. In patients with acquired immunodeficiency syndrome who have
cryptococcal meningitis, pulmonary cryptococcal disease is common and
must be distinguished from other opportunistic infections.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ;
Cryptococcosis/ETIOLOGY/*PATHOLOGY ; Human ; Irrigation ; Kidney/
MICROBIOLOGY/PATHOLOGY ; Lung/MICROBIOLOGY/PATHOLOGY ; Lung Diseases,
Fungal/ETIOLOGY/*PATHOLOGY ; Meningitis/ETIOLOGY/PATHOLOGY ; Pulmonary
Alveoli/MICROBIOLOGY/PATHOLOGY
SO - Arch Pathol Lab Med 1986 Jun;110(6):502-7
41
UI - 86141973
AU - Haase AT
TI - The pathogenesis of slow virus infections: molecular analyses.
AB - Slow infections raise some novel issues in understanding the pathogenesis
of viral diseases that have been increasingly addressed at the molecular
level with in situ hybridization. These developments are reviewed as the
framework for discussion of the realized and potential impact of these
investigations for major neurological afflictions of humans and for AIDS.
MH - Acquired Immunodeficiency Syndrome/MICROBIOLOGY ; Adult ; Aged ;
Alzheimer's Disease/MICROBIOLOGY ; Animal ; DNA/ANALYSIS ; DNA, Viral/
METABOLISM ; Gene Expression Regulation ; Human ; Lysogeny ; Measles
Virus/*GENETICS ; Nucleic Acid Hybridization ; Reverse Transcriptase/
METABOLISM ; RNA, Viral/ANALYSIS ; Scrapie/FAMILIAL & GENETIC/
*MICROBIOLOGY ; Slow Virus Diseases/*ETIOLOGY ; Support, Non-U.S. Gov't ;
Support, U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S. ;
Visna-Maedi Viruses/PATHOGENICITY
SO - J Infect Dis 1986 Mar;153(3):441-7
42
UI - 86211753
AU - Post MJ ; Hensley GT ; Moskowitz LB ; Fischl M
TI - Cytomegalic inclusion virus encephalitis in patients with AIDS: CT,
clinical, and pathologic correlation.
AB - The computed tomographic (CT) scans of 10 patients with acquired
immunodeficiency syndrome who had central nervous system (CNS)
involvement by cytomegalovirus (CMV) were retrospectively reviewed and
correlated with clinical data and pathologic findings. Diagnosis was
established in all 10 patients by autopsy, which showed the pathognomonic
"owl's eye: intracellular inclusions of CMV. In six patients CMV caused
an initial CNS infection that was directly responsible for the patient's
progressive encephalopathy and death. In four patients CMV caused a
superimposed nondominant CNS infection that had no clinical expression in
two. Cortical atrophy and mild hydrocephalus ex vacuo were seen on CT in
all 10 patients. Positive findings on CT that could be attributed to
infection with CMV were present in only three of the 10 patients, and in
these three symptomatic cases autopsy correlation revealed that CT
underestimated the degree of CNS involvement. In the other three
symptomatic patients, CT showed nonormalities, while
autopsy demonstrated diffuse cerebral involvement. In the four patients
whose CNS was secondarily involved by CMV, CT showed changes proven at
autopsy to be related only to the dominant infection with Toxoplasma
gondii and to postoperative hematomas. CT did not demonstrate any
abnormalities at the sites of CMV involvement, which were found at
autopsy in this latter group. It was concluded that CT is not very
sensitive for the detection of CMV encephalitis.
MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/PATHOLOGY/*RADIOGRAPHY ;
Adult ; Brain/PATHOLOGY/*RADIOGRAPHY ; Cytomegalic Inclusion Disease/
COMPLICATIONS/PATHOLOGY/*RADIOGRAPHY ; Cytomegaloviruses ; Encephalitis/
MICROBIOLOGY/PATHOLOGY/*RADIOGRAPHY ; Female ; Florida ; Haiti/ETHNOLOGY
; Homosexuality ; Human ; Male ; Middle Age ; Nuclear Magnetic Resonance/
DIAGNOSTIC USE ; Papovaviridae ; Retrospective Studies ; *Tomography,
X-Ray Computed ; Toxoplasma ; Tumor Virus Infections/RADIOGRAPHY
SO - AJR 1986 Jun;146(6):1229-34
43
UI - 86205560
AU - Delisle MB ; Bouissou H ; Saidi A
TI - What's new in cerebral pathology in acquired immune deficiencies?
AB - Over the last few decades, a new pathology has appeared, directly related
to the modified immune status of the hosts. It presents several
distinctive points. The central nervous system is particularly affected.
The opportunistic pathogenic agents do not usually injure the brain
parenchyma and are not known for their aggressiveness in normal adults
(papovavirus). Diagnosis of these different diseases is often difficult,
some biological tests being irrelevant because of alterations of the
immune system (toxoplasmosis). The lesions may be exclusively located in
the brain (tuberculosis, lymphomas) which is not usually affected by
these agents. Response to therapy is frequently poor, the clinical course
being rapid and fatal. However, therapy may be successful in some cases,
justifying the use of somewhat aggressive procedures (biopsy) in order to
obtain an accurate diagnosis. It is important to be aware of these data,
and an understanding of them may help in managing these already difficult
patients. They also make possible some interesting pathogenic hypotheses.
MH - Acquired Immunodeficiency Syndrome/PATHOLOGY ; Adult ; Bacterial
Infections/DIAGNOSIS ; Brain/*PATHOLOGY ; Brain Neoplasms/ETIOLOGY/
PATHOLOGY ; Cytomegalic Inclusion Disease/ETIOLOGY/PATHOLOGY ;
Encephalitis/ETIOLOGY/PATHOLOGY ; Female ; Human ; Immunologic Deficiency
Syndromes/COMPLICATIONS/*PATHOLOGY ; Leukoencephalopathy, Progressive
Multifocal/ETIOLOGY/PATHOLOGY ; Lymphoma/ETIOLOGY/PATHOLOGY ; Male ;
Middle Age ; Mycoses/DIAGNOSIS ; Review ; Toxoplasmosis/ETIOLOGY/
PATHOLOGY ; Transplantation/ADVERSE EFFECTS ; Virus Diseases/DIAGNOSIS
SO - Pathol Res Pract 1986 Mar;181(1):85-92
44
UI - 86196983
AU - Post MJ ; Curless RG ; Gregorios JB ; Scott GB ; Sheldon JJ
TI - Reactivation of congenital cytomegalic inclusion disease in an infant
with HTLV-III associated immunodeficiency: a CT-pathologic correlation.
AB - Serial CT findings in an infant with HTLV-III infection and cytomegalic
inclusion virus encephalitis are presented.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Case Report ;
Comparative Study ; Cytomegalic Inclusion Disease/*CONGENITAL ;
Encephalitis/*ETIOLOGY/PATHOLOGY/RADIOGRAPHY ; Female ; Human ; Infant ;
Retrovirus Infections/*COMPLICATIONS ; Tomography, X-Ray Computed
SO - J Comput Assist Tomogr 1986 May-Jun;10(3):533-6
45
UI - 86185611
AU - Pippard MJ ; Dalgleish A ; Gibson P ; Malkovsky M ; Webster AD
TI - Acquired immunodeficiency with disseminated cryptococcosis.
AB - A 9 year old Portuguese boy presented with severe wasting and a
disseminated cryptococcal infection that resolved after massive doses of
intrathecal and parenteral antifungal agents. Clinical and laboratory
findings were consistent with AIDS. Apart from neonatal blood
transfusions, there were no identified risk factors for HTLV III
infection.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY ; Brain
Diseases/CEREBROSPINAL FLUID/ETIOLOGY ; Case Report ; Cerebral Cortex/
PATHOLOGY ; Child ; Cryptococcosis/CEREBROSPINAL FLUID/DRUG THERAPY/
*ETIOLOGY ; Human ; Male
SO - Arch Dis Child 1986 Mar;61(3):289-91
46
UI - 86185367
AU - Navia BA ; Petito CK ; Gold JW ; Cho ES ; Jordan BD ; Price RW
TI - Cerebral toxoplasmosis complicating the acquired immune deficiency
syndrome: clinical and neuropathological findings in 27 patients.
AB - We reviewed the clinical, neuroradiological, and serological findings in
27 patients with cerebral toxoplasmosis complicating the acquired immune
deficiency syndrome, 19 of whom were also analyzed neuropathologically.
The clinical manifestations of this disorder varied, ranging from
headache and fever to coma. However, the characteristic presentation
included focal neurological symptoms and signs, usually of subacute
onset. In addition, two-thirds of the patients exhibited more generalized
cerebral dysfunction with confusion and lethargy. The computed
tomographic (CT) scan most commonly revealed ring contrast enhancement,
which appeared to correlate best with the histological presence of
vascular proliferation and inflammation surrounding the abscesses.
However, in 5 patients the CT scan revealed either homogeneous
enhancement or no enhancement, and in 3 patients the scans were negative.
In general, CT scans underrepresented the number of lesions eventually
documented pathologically. Double-dose contrast administration and
preliminary experience with magnetic resonance imaging suggested that
these techniques were superior to standard CT scanning in detecting
Toxoplasma lesions. All patients were seropositive for IgG antibody
against Toxoplasma gondii in blood, both before the onset of illness and
at the time of presentation, although titers in some patients were as low
as 1:8 and most patients did not exhibit rising titers. Prompt therapy
resulted in rapid clinical improvement, documented by CT scan, associated
with the development of an organizing tissue response in the host and
elimination of free organisms. Response to treatment was sufficiently
rapid in most patients to allow a trial of therapy as the favored
approach to diagnosis.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ;
Biopsy ; Brain Diseases/*COMPLICATIONS/DRUG THERAPY/PATHOLOGY/RADIOGRAPHY
; Case Report ; Central Nervous System/*PATHOLOGY/RADIOGRAPHY ;
Clindamycin/THERAPEUTIC USE ; Human ; Male ; Middle Age ; Pyrimethamine/
THERAPEUTIC USE ; Serology ; Sulfonamides/THERAPEUTIC USE ; Support,
Non-U.S. Gov't ; Tomography, X-Ray Computed ; Toxoplasmosis/
*COMPLICATIONS/DRUG THERAPY/PATHOLOGY/RADIOGRAPHY
SO - Ann Neurol 1986 Mar;19(3):224-38
47
UI - 86185356
AU - Ryder JW ; Croen K ; Kleinschmidt-DeMasters BK ; Ostrove JM ; Straus SE ;
Cohn DL
TI - Progressive encephalitis three months after resolution of cutaneous
zoster in a patient with AIDS.
AB - A 37-year-old homosexual man with the acquired immune deficiency syndrome
(AIDS) developed progressive, ultimately fatal, neurological deficits 12
weeks after a course of cutaneous zoster. Premortem radiological
procedures and cerebrospinal fluid analyses were nondiagnostic. At
postmortem examination, several opportunistic infections associated with
AIDS were recognized. Throughout the brain, necrotic and demyelinative
lesions were present, suggestive of progressive multifocal
leukoencephalopathy. However, light microscopical examination showed
numerous Cowdry type A intranuclear inclusions in astrocytes,
oligodendrocytes, and neurons near the periphery of the lesions. Herpes
zoster encephalomyelitis was diagnosed and confirmed by electron
microscopy, peroxidase-antiperoxidase staining, and by Southern blot
analysis of DNA extracted from brain tissue. This case provides insight
into the pathogenesis of zoster-associated encephalomyelitis and suggests
another agent to be considered in the differential diagnosis of
encephalopathy in patients with AIDS and other disorders of immunological
impairment.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ;
Brain/*PATHOLOGY ; Case Report ; Encephalomyelitis/*COMPLICATIONS/
DIAGNOSIS/PATHOLOGY ; Herpes Zoster/*COMPLICATIONS/DIAGNOSIS/PATHOLOGY ;
Human ; Male ; Microscopy, Electron ; Support, Non-U.S. Gov't ; Support,
U.S. Gov't, P.H.S.
SO - Ann Neurol 1986 Feb;19(2):182-8
48
UI - 86177586
AU - Stoner GL ; Ryschkewitsch CF ; Walker DL ; Webster HD
TI - JC papovavirus large tumor (T)-antigen expression in brain tissue of
acquired immune deficiency syndrome (AIDS) and non-AIDS patients with
progressive multifocal leukoencephalopathy.
AB - Progressive multifocal leukoencephalopathy (PML) is a JC papovavirus
infection of the central nervous system in immunocompromised patients. It
is well established that demyelination in PML is caused by JC virus
infection of oligodendroglia, but whether the nonstructural regulatory
protein, large tumor (T) antigen, is detectable in infected human tissue
was not known. Using a modification of the peroxidase-antiperoxidase
technique, we found T antigen expressed in the nuclei of cells in
virus-infected sites in five cases of PML studied, including two with
acquired immune deficiency syndrome (AIDS). PML occurs in AIDS at a much
higher frequency than in other immunosuppressive disorders, and PML in
AIDS may represent a more severe form of JC virus infection of the
central nervous system.
MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*MICROBIOLOGY ; Antigens,
Viral, Tumor/*ANALYSIS ; Brain/IMMUNOLOGY/*MICROBIOLOGY ; Cell
Transformation, Viral ; Fixatives ; Human ; JC Virus/*IMMUNOLOGY ;
Leukoencephalopathy, Progressive Multifocal/IMMUNOLOGY/*MICROBIOLOGY ;
Polyomaviruses/*IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S.
Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S.
SO - Proc Natl Acad Sci USA 1986 Apr;83(7):2271-5
49
UI - 86170569
AU - Bahls F ; Sumi SM
TI - Cryptococcal meningitis and cerebral toxoplasmosis in a patient with
acquired immune deficiency syndrome.
AB - A 34-year-old homosexual male developed cryptococcal meningitis as the
initial manifestation of Acquired Immune Deficiency Syndrome (AIDS). With
antifungal therapy he improved. Six weeks later he developed focal motor
seizures and progressive hemiplegia. Computer assisted tomography
revealed multiple, ring-enhancing, low density lesions. The patient
expired and at necropsy he was found to have multiple toxoplasma brain
abscesses as well as chronic cryptococcal meningitis. This case
demonstrates that in a patient with AIDS with pre-existing central
nervous system infection who develops new neurological symptoms the
possibility of a second and potentially treatable infection must be
considered and its diagnosis pursued vigorously.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ;
Brain/*PATHOLOGY ; Brain Diseases/*COMPLICATIONS ; Case Report ;
Cryptococcosis/*COMPLICATIONS/PATHOLOGY ; Human ; Male ; Meningitis/
*COMPLICATIONS/PATHOLOGY ; Toxoplasmosis/*COMPLICATIONS/PATHOLOGY
SO - J Neurol Neurosurg Psychiatry 1986 Mar;49(3):328-30
50
UI - 86159979
AU - Beresford TP ; Blow FC ; Hall RC
TI - AIDS encephalitis mimicking alcohol dementia and depression.
AB - The authors report a case of encephalitis occurring in a setting
consistent with acquired immune deficiency syndrome (AIDS). They point
out that AIDS and its complications can mimic psychiatric syndromes,
including depression and dementia, or delirium related to illnesses such
as alcoholism. Acting out behavior, seen in the present case, may also be
mistaken as a symptom of sociopathy.
MH - Acquired Immunodeficiency Syndrome/*DIAGNOSIS ; Adult ; Alcoholism/
*DIAGNOSIS ; Case Report ; Dementia/*CHEMICALLY INDUCED ; Depressive
Disorder/*DIAGNOSIS ; Diagnostic Errors ; Encephalitis/*DIAGNOSIS ; Human
; Male
SO - Biol Psychiatry 1986 Apr;21(4):394-7
51
UI - 86142149
AU - Beckham MM ; Rudy EB
TI - Acquired immunodeficiency syndrome: impact and implication for the
neurological system.
AB - Acquired immunodeficiency syndrome (AIDS) has reached epidemic
proportions throughout the world. Because at least 40% of AIDS victims
are neurologically symptomatic, the neuroscience nurse must be prepared
to care for increasing numbers of these patients. This article will
define the syndrome, identify risk groups, and discuss the possible
etiology. An explanation of the immune system will facilitate
understanding of AIDS and its impact on the neurological system. The role
of the nurse will be considered, with emphasis on the psychosocial
implications of the syndrome for its victims.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY/NURSING/
TRANSMISSION ; Attitude of Health Personnel ; Central Nervous System
Diseases/ETIOLOGY/IMMUNOLOGY ; Fear ; Human ; Immunity ; Nervous System
Diseases/*ETIOLOGY/IMMUNOLOGY/NURSING ; Nurses/PSYCHOLOGY ; Nursing
Assessment ; Risk
SO - J Neurosci Nurs 1986 Feb;18(1):5-10
52
UI - 86138293
AU - Sharer LR ; Epstein LG ; Cho ES ; Joshi VV ; Meyenhofer MF ; Rankin LF ;
Petito CK
TI - Pathologic features of AIDS encephalopathy in children: evidence for
LAV/HTLV-III infection of brain.
AB - The neuropathologic findings in 11 children with a new CNS disorder that
occurs in children with the acquired immunodeficiency syndrome (AIDS) and
is postulated to be due to LAV/HTLV-III, the virus that causes AIDS, are
reported. The children, who ranged in age from 4 months to 11 years, died
of AIDS complicated by progressive encephalopathy. Ten of the children
either had positive serum antibody for LAV/HTLV-III or had received blood
products from donors later found to be antibody-positive. Examination of
the brains of these children at autopsy revealed a unique constellation
of findings, including varying degrees of diminished brain weight in all
cases, inflammatory cell infiltrates in nine brains, multinucleated cells
in eight, three of which also contained multinucleated giant cells,
vascular calcification in ten, vascular and perivascular inflammation in
five, and white matter changes in nine. Inflammatory and vascular lesions
were most prominent in basal ganglia and pons. LAV/HTLV-III retroviral
particles, associated with multinucleated giant cells, were observed in
two brains on electron microscopic examination. These two and one
additional brain had evidence of the LAV/HTLV-III genome by hybridization
studies. Only one brain had a recognizable opportunistic infection.
MH - Acquired Immunodeficiency Syndrome/MICROBIOLOGY/*PATHOLOGY ; Antibodies,
Viral/ANALYSIS ; Atrophy/PATHOLOGY ; Autopsy ; Base Sequence ; Blood
Transfusion/ADVERSE EFFECTS ; Brain/BLOOD SUPPLY/MICROBIOLOGY/*PATHOLOGY
; Case Report ; Child ; Child, Preschool ; Encephalitis/MICROBIOLOGY/
*PATHOLOGY ; Female ; Human ; Human T-Cell Leukemia Virus/GENETICS/
IMMUNOLOGY/*ULTRASTRUCTURE ; Infant ; Inflammation/PATHOLOGY ; Lymphatic
Diseases/*MICROBIOLOGY ; Male ; Microscopy, Electron ; Retrovirus
Infections/MICROBIOLOGY ; Virion/ULTRASTRUCTURE
SO - Hum Pathol 1986 Mar;17(3):271-84
53
UI - 86134315
AU - Anders K ; Steinsapir KD ; Iverson DJ ; Glasgow BJ ; Layfield LJ ; Brown
WJ ; Cancilla PA ; Verity MA ; Vinters HV
TI - Neuropathologic findings in the acquired immunodeficiency syndrome
(AIDS).
AB - The acquired immunodeficiency syndrome (AIDS) is characterized by a
severe idiopathic deficiency in T-cell mediated immunity. Homosexuals,
intravenous drug abusers and Haitians are predominantly affected,
predisposing them to opportunistic infections and neoplasms. In this
study, the central nervous system (CNS) was examined at autopsy in 29
AIDS patients. Significant CNS complications occurred in 55%, mainly
related to opportunistic infections similar to those seen in patients
with other causes of immunosuppression. Progressive multifocal
leukoencephalopathy (three cases), cytomegalovirus (CMV) encephalitis
(five cases), cryptococcal meningitis (four cases), Mycobacterium
avium-intracellulare (three cases), and toxoplasmosis (one case) were
found. Widespread microglial nodules were observed in 20 patients, 80% of
whom had CMV inclusions elsewhere at autopsy. Primary cerebral lymphoma
(one case) and lymphomatoid granulomatosis (one case) were present.
Subarachnoid (five cases) and intraparenchymal (three cases) hemorrhage
was seen although these were not usually clinically significant. A single
case of embolic arterial obstruction with cortical infarction was due to
non-bacterial thrombotic endocarditis.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ;
Brain/*PATHOLOGY ; Brain Diseases/*COMPLICATIONS ; Human ; Lymphoma/
COMPLICATIONS ; Lymphomatoid Granulomatosis/COMPLICATIONS ; Male ; Middle
Age ; Mycoses/COMPLICATIONS ; Protozoan Infections/COMPLICATIONS ;
Sarcoma, Kaposi's/COMPLICATIONS ; Support, Non-U.S. Gov't ; Virus
Diseases/COMPLICATIONS
SO - Clin Neuropathol 1986 Jan-Feb;5(1):1-20
54
UI - 86128605
AU - Zuger A ; Louie E ; Holzman RS ; Simberkoff MS ; Rahal JJ
TI - Cryptococcal disease in patients with the acquired immunodeficiency
syndrome. Diagnostic features and outcome of treatment.
AB - Between 1 January 1981 and 1 December 1984, 34 of 396 patients with the
acquired immunodeficiency syndrome (AIDS) developed cryptococcal
infections. Twenty-six cases are reviewed. Twenty-two patients had brain
or meningeal disease; the others had pulmonary disease (2 patients),
pericarditis (1 patient), and antigenemia (1 patient). During treatment,
3 patients died of cryptococcosis and 3 died of other causes. Fifteen
patients were followed for more than 6 weeks after treatment. Of 8
patients who received no additional amphotericin B, 4 had relapses and
died of cryptococcosis within 6 months, 3 died of other causes, and 1
survived. Of 7 patients who received maintenance therapy with
amphotericin B, none had relapses, 3 died of other causes, and 4
survived. Our data suggest that maintenance therapy with amphotericin may
be needed to prevent relapse in patients with AIDS.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Amphotericin
B/*THERAPEUTIC USE ; Brain Diseases/CEREBROSPINAL FLUID/ETIOLOGY/
RADIOGRAPHY ; Cryptococcosis/DIAGNOSIS/ETIOLOGY/MORTALITY/*THERAPY ; Drug
Therapy, Combination ; Female ; Flucytosine/THERAPEUTIC USE ; Human ;
Injections, Intravenous ; Injections, Intraventricular ; Male ;
Meningitis/CEREBROSPINAL FLUID/ETIOLOGY ; Middle Age ; Prognosis ;
Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed
SO - Ann Intern Med 1986 Feb;104(2):234-40
55
UI - 86097293
AU - Polsky B ; Gold JW
TI - The acquired immune deficiency syndrome.
AB - Although the etiologic agent of AIDS has been identified, clinicians are
still left with treating the complications of this immune deficiency,
that is, the unusual neoplasms such as KS and the myriad of opportunistic
infections. Efforts at immune reconstitution, including bone marrow
transplantation from a normal identical twin to his brother with AIDS,
have been unsuccessful. The transplanted lymphocytes are as likely to
become infected as the patient's own. Therefore, future efforts must be
directed at defining the natural history and infectivity of individuals
showing evidence of HTLV III or LAV infection and toward specific
antiviral therapy for those with infection and a vaccine for those at
high risk for HTLV III infection and, consequently, AIDS.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY/THERAPY ;
Bacterial Infections/ETIOLOGY ; Candidiasis/ETIOLOGY ; Cryptococcosis/
ETIOLOGY ; Cryptosporidiosis/ETIOLOGY ; Cytomegalic Inclusion Disease/
ETIOLOGY ; Encephalitis/ETIOLOGY ; Female ; Herpes Simplex/ETIOLOGY ;
Human ; Leukoencephalopathy, Progressive Multifocal/ETIOLOGY ; Male ;
Mycobacterium Infections, Atypical/ETIOLOGY ; Pneumonia, Pneumocystis
Carinii/ETIOLOGY ; Review ; Salmonella Infections/ETIOLOGY ; Sarcoma,
Kaposi's/ETIOLOGY ; T Lymphocytes/IMMUNOLOGY ; Toxoplasmosis/ETIOLOGY
SO - Surg Annu 1986;18:280-95
56
UI - 86068923
AU - Post MJ ; Sheldon JJ ; Hensley GT ; Soila K ; Tobias JA ; Chan JC ;
Quencer RM ; Moskowitz LB
TI - Central nervous system disease in acquired immunodeficiency syndrome:
prospective correlation using CT, MR imaging, and pathologic studies.
AB - A prospective study compared the abilities of high-resolution computed
tomography (HRCT) and magnetic resonance (MR) imaging in detection and
evaluation of central nervous system disease in neurologically
symptomatic patients with acquired immunodeficiency syndrome (AIDS).
Eighteen CT scans and 19 MR images in 14 patients were compared. HRCT
images with contrast material enhancement were superior to unenhanced
0.35-T MR images for differentiating a lesion from surrounding edema,
discriminating between lesions in close proximity, locating lesions for
biopsy, judging lesion activity, detecting small cortical lesions with
minimal edema, and spatial resolution. MR imaging was superior to CT
scanning in evaluation of white-matter lesions and detection of small
lesions surrounded by edema. MR imaging exhibited higher contrast
resolution and greater sensitivity. Complementary uses of MR and CT
imaging are suggested.
MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Brain/
PATHOLOGY ; Brain Diseases/COMPLICATIONS/*DIAGNOSIS/PATHOLOGY/RADIOGRAPHY
; Comparative Study ; Female ; Human ; Male ; Middle Age ; Nuclear
Magnetic Resonance/DIAGNOSTIC USE ; Prospective Studies ; Tomography,
X-Ray Computed
SO - Radiology 1986 Jan;158(1):141-8