Central pontine myelinolysis in advanced HIV infection with tuberculosis and multicentric Castleman's disease

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Published on: March 24, 2023

J Katchanov1, G Branding, H Stocker

  • 1Department of Infectious Diseases and Gastroenterology, Auguste-Viktoria-Klinikum, Rubensstraße 125 12157 Berlin. juri.katchanov@charite.de

International Journal of STD & AIDS
|August 24, 2013
PubMed

Insights

Central pontine myelinolysis (CPM) in advanced HIV infection can present atypically. This case shows the first reported full clinical and radiological recovery from CPM in advanced HIV disease.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Radiology

Background:

  • Advanced HIV infection poses diverse neurological risks.
  • Miliary tuberculosis is a severe disseminated form of tuberculosis.
  • Central pontine myelinolysis (CPM) is a rare neurological condition.

Observation:

  • A patient with advanced HIV and miliary tuberculosis developed an unusual ataxic variant of CPM.
  • The patient experienced a complete clinical recovery during hospitalization.
  • Follow-up imaging demonstrated resolution of the pontine lesions.

Findings:

  • This is the first reported case of clinical and radiological recovery from CPM in the context of advanced HIV disease.
  • The patient's recovery occurred despite the absence of electrolyte derangements, a common trigger for CPM.
  • The presentation was an ataxic syndrome, an uncommon manifestation of CPM.

Implications:

  • Highlights the spectrum of neurological complications in advanced HIV infection.
  • Suggests CPM should be considered in HIV patients with ataxic syndromes, irrespective of electrolyte status.
  • Demonstrates the potential for recovery from CPM in immunocompromised individuals with appropriate management.
Keywords:
AIDSAfricaEuropeHIVMycobacterium tuberculosisTBcentral pontine myelinolysismulticentric Castleman's disease

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