American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2019, 7(1), 5-8
DOI: 10.12691/ajmcr-7-1-2
Open AccessCase Report

A Rare Case of HIV-Induced Inflammatory Demyelinating Polyneuropathy

Abin Sajan BS1, Soombal Zahid DO2, Jordan Stumph MD2, Daniel Griepp BE1, Sami Saba MD2, Nazish Ilyas MD2 and Isabel M. Mc Farlane MD1,

1Department of Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue Brooklyn, NY 11203 (718) 270-2030

2Department of Medicine, Lenox Hill Hospital, Department of Medicine, 100 E 77th Street New York, NY 10075 (212) 434-2000

Pub. Date: January 21, 2019

Cite this paper:
Abin Sajan BS, Soombal Zahid DO, Jordan Stumph MD, Daniel Griepp BE, Sami Saba MD, Nazish Ilyas MD and Isabel M. Mc Farlane MD. A Rare Case of HIV-Induced Inflammatory Demyelinating Polyneuropathy. American Journal of Medical Case Reports. 2019; 7(1):5-8. doi: 10.12691/ajmcr-7-1-2

Abstract

Background: Acute inflammatory demyelinating polyneuropathy (AIDP) is an uncommon form of neuropathy in HIV-infected patients that can cause pain, sensory disturbance, and motor weakness. Case presentation: A 23-year-old African American male with past medical history of Guillain-Barre Syndrome (GBS), Lyme disease, and sexually transmitted infections including syphilis and chlamydia presented with acute back pain radiating to bilateral lower extremities with worsening right foot weakness for four days. Cerebrospinal fluid (CSF) studies including meningoencephalitis panel were negative as well as blood tests for Lyme disease and HIV antibody testing. Patient was initially treated with penicillin for positive treponemal serology but without improvement in lower extremity weakness. Electromyogram showed evidence of early demyelinating motor polyneuropathy. Four days after presentation, repeat HIV antibody testing returned positive. Recurrent AIDP in this case was suspected to be secondary to acute HIV infection, and highly active antiretroviral therapy (HAART) was administered along with intravenous immunoglobulin (IVIG). Muscle strength improved with therapy and patient was expected to have continued improvement with intensive rehabilitation after discharge. Conclusion: Acute inflammatory demyelinating polyneuropathy (AIDP) tends to present early in course of HIV infection. Therefore, HIV testing should be obtained in individuals presenting with new neurological deficits. Our patient received HAART therapy, in addition to the traditional modalities to manage AIDP, which led to a substantial recovery of his sensorimotor function.

Keywords:
human immunodeficiency virus acute inflammatory demyelinating polyneuropathy Guillain-Barre syndrome intravenous immunoglobulin peripheral neuropathy chronic inflammatory demyelinating polyneuropathy highly active antiretroviral therapy

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