Human immunodeficiency virus seroconversion presenting with acute inflammatory demyelinating polyneuropathy: a case report

Derek J Sloan, Andrew Nicolson, Alastair RO Miller, Nick J Beeching, Mike BJ Beadsworth

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7 Citations (Scopus)

Abstract

Introduction: Acute Human Immunodeficiency Virus infection is associated with a range of neurological conditions. Guillain-Barré syndrome is a rare presentation; acute inflammatory demyelinating polyneuropathy is the commonest form of Guillain-Barré syndrome. Acute inflammatory demyelinating polyneuropathy has occasionally been reported in acute Immunodeficiency Virus infection but little data exists on frequency, management and outcome.

Case presentation:  We describe an episode of Guillain-Barré syndrome presenting as acute inflammatory demyelinating polyneuropathy in a 30-year-old man testing positive for Immunodeficiency Virus, probably during acute seroconversion. Clinical suspicion was confirmed by cerebrospinal fluid analysis and nerve conduction studies. Rapid clinical deterioration prompted intravenous immunoglobulin therapy and early commencement of highly active anti-retroviral therapy. All symptoms resolved within nine weeks.

Conclusion:  Unusual neurological presentations in previously fit patients are an appropriate indication for Immunodeficiency-Virus testing. Highly active anti-retroviral therapy with adequate penetration of the central nervous system should be considered as an early intervention, alongside conventional therapies such as intravenous immunoglobulin.
Original languageEnglish
Article number370
Number of pages5
JournalJournal of Medical Case Reports
Volume2
DOIs
Publication statusPublished - 4 Dec 2008

Keywords

  • Human immunodeficiency virus
  • Efavirenz
  • Human immunodeficiency virus testing
  • Intravenous immunoglobulin therapy
  • Acute inflammatory demyelinating polyneuropathy

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