PMID- 31214917
OWN - NLM
STAT- MEDLINE
DCOM- 20201021
LR  - 20201021
IS  - 1538-2443 (Electronic)
IS  - 1355-0284 (Linking)
VI  - 25
IP  - 6
DP  - 2019 Dec
TI  - The "milky way" galaxy of HIV-related central nervous system immune reaction 
      syndromes.
PG  - 887-892
LID - 10.1007/s13365-019-00769-4 [doi]
AB  - The landscape of central nervous system HIV infection is rapidly changing, 
      leading to the recognition of a new constellation of overlapping syndromes and to 
      a better insight for the elder ones. Among these, progressive multifocal 
      leukoencephalopathy (PML) still poses several diagnostic and therapeutic 
      challenges; nevertheless, recent developments in understanding PML in patients 
      with multiple sclerosis may have benefitted HIV-positive patients suffering from 
      PML too. We describe a peculiar case of PML-immune reconstitution inflammatory 
      syndrome (IRIS) presenting a punctate pattern with "milky way" appearance on 
      magnetic resonance imaging. Despite the fact that brain imaging and 
      histopathology remain the mainstays for extricating through the expanding galaxy 
      of HIV-related central nervous system dysimmune syndromes and although punctate 
      pattern has been already well acknowledged as a suggestive finding of PML among 
      patients on natalizumab, this radiological presentation is still poorly 
      recognised in AIDS-related PML cases, leading to possible life-threatening 
      diagnostic delays. This is also the first report about intravenous immunoglobulin 
      treatment in AIDS-related PML-IRIS; the favourable clinical and radiological 
      outcome of our case and the preliminary administrations of intravenous 
      immunoglobulins in natalizumab-associated PML-IRIS from literature support 
      probable benefits also among HIV-positive patients.
FAU - Trunfio, Mattia
AU  - Trunfio M
AUID- ORCID: 0000-0001-8663-719X
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy. 
      mattia.trunfio@edu.unito.it.
FAU - Manini, Claudia
AU  - Manini C
AD  - Unit of Pathology, San Giovanni Bosco Hospital, Piazza Donatore di Sangue 3, 
      10154, Torino, Italy.
FAU - Trentalange, Alice
AU  - Trentalange A
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy.
FAU - Boghi, Andrea
AU  - Boghi A
AD  - Unit of Neuroradiology, San Giovanni Bosco Hospital, Piazza Donatore di Sangue 3, 
      10154, Torino, Italy.
FAU - Audagnotto, Sabrina
AU  - Audagnotto S
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy.
FAU - Imperiale, Daniele
AU  - Imperiale D
AD  - Unit of Neurology, Maria Vittoria Hospital, Via Luigi Cibrario 72, 10144, Torino, 
      Italy.
FAU - Taraglio, Stefano
AU  - Taraglio S
AD  - Unit of Pathology, San Giovanni Bosco Hospital, Piazza Donatore di Sangue 3, 
      10154, Torino, Italy.
FAU - Bonora, Stefano
AU  - Bonora S
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy.
FAU - Di Perri, Giovanni
AU  - Di Perri G
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy.
FAU - Calcagno, Andrea
AU  - Calcagno A
AD  - Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia 
      Hospital, University of Torino, Corso Svizzera 164, 10149, Torino, Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190618
PL  - United States
TA  - J Neurovirol
JT  - Journal of neurovirology
JID - 9508123
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adult
MH  - Brain/pathology
MH  - HIV Infections/*complications/drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/*pathology
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Leukoencephalopathy, Progressive Multifocal/drug therapy/*pathology
MH  - Male
OTO - NOTNLM
OT  - Central nervous system
OT  - HIV
OT  - Immune reconstitution inflammatory syndrome
OT  - Immunoglobulins
OT  - Progressive multifocal leukoencephalopathy
OT  - Punctate pattern
EDAT- 2019/06/20 06:00
MHDA- 2020/10/22 06:00
CRDT- 2019/06/20 06:00
PHST- 2018/11/13 00:00 [received]
PHST- 2019/05/24 00:00 [accepted]
PHST- 2019/05/18 00:00 [revised]
PHST- 2019/06/20 06:00 [pubmed]
PHST- 2020/10/22 06:00 [medline]
PHST- 2019/06/20 06:00 [entrez]
AID - 10.1007/s13365-019-00769-4 [pii]
AID - 10.1007/s13365-019-00769-4 [doi]
PST - ppublish
SO  - J Neurovirol. 2019 Dec;25(6):887-892. doi: 10.1007/s13365-019-00769-4. Epub 2019 
      Jun 18.