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Atypical HIV-vacuolar myelopathy: a case report

Authors
  • Mongezi, Tau1
  • Sibi, Joseph2
  • Jerry, George2
  • Lourdes de Fátima, Ibañez-Valdés2
  • Tozama, Dubula3
  • Humberto, Foyaca Sibat2
  • 1 Nelson Mandela Academic Central Hospital (NMACH), Walter Sisulu University, Mthatha, South Africa , Mthatha (South Africa)
  • 2 NMACH, Walter Sisulu University, Mthatha, South Africa , Mthatha (South Africa)
  • 3 Water Sisulu University (WSU), Mthatha, South Africa , Mthatha (South Africa)
Type
Published Article
Journal
European Journal of Medical Research
Publisher
BioMed Central
Publication Date
Feb 01, 2021
Volume
26
Issue
1
Identifiers
DOI: 10.1186/s40001-021-00483-0
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundHere, we report an atypical HIV-vacuolar myelopathy and search the available medical literature about atypical presentations of human immunodeficiency virus associate vacuolar myelopathy (HIV-VM) and immunoglobulin therapy response.CaseA 26-year-old lady who was 4 weeks postpartum presented to us with acute flaccid quadriparesis, with no sensory level. Extensive workup ruled out other causes of myelopathy. She developed a stage 3 acute kidney injury, and MRI showed diffuse cord atrophy involving the lower cervical and thoracic cord. The patient received IV-immunoglobulin, ARVs, and supportive therapy with inadequate response. Unfortunately, she developed nosocomial pneumonia and died.DiscussionIn HIV-VM, there is spinal cord atrophy, which mainly involves the thoracic cord. In our case, this pathological process also affected the spinal cord's cervical region, leading to flaccid tetraplegia, with high CD4 level, without response to the treatment, including intravenous immunoglobulin.KeynotesVacuolar myelopathy, HIV, Immunoglobulin therapy, flaccid tetraplegia, hypokalaemia. Renal failure.

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