IN NEURO--AIDS FILED THE DIFFERENTIAL DIAGNOSIS BETWEEN PML AND HIV ENCEPHALOPATHY SEEM QUITE DEFINITE. NEVERTHELESS SOME DIFFICULTIES ARISE, MAINLY AT THE BEGINNING OF THE DISEASE, WHEN HIV ENCEPHALOPATHY MANIFESTS ITSELF AS HIV LEUKOENCEPHALOPATHY (HIVL). THE PRESENT STUDY AIMS TO IDENTIFY SOM E DISTINGUISHING CRITERIA BETWEEN PML AND HIVL. METHODS: SUBJECTS WITH PATHOLOGICALLY PROVED PML OR HIVL WITHOUT CEREBRAL COINFECTIONS WERE NEUROLOGICALLY , NEURORADIOLOGICALLY AND IMMUNOLOGICALLY EVALUATED. RESULTS: 10 PATIENTS WERE AFFECTED BY PML WHILE 9 WERE AFFECTED BY HIVL. FROM A CLINICAL POINT OF VIEW PML ONSET IS SUBACUTE WHILE HIVL ONE IS INSIDIOUS; PML IS CHARACTERIZED BY NEUROLOGICAL SIGNS OF CORTICAL INCOLVEMENT WHILE HIVL NEUROLOGICAL DEFICITS ARE MAINLY SUBCORTICAL. FROM A NEUROPSYCHOLOGICAL POINT OF VIEW PML PRESENTS MAINLY LANGUAGE DEFICITS , WHILE HIVL PATIENTS HAVE MEMORY DEFICITS AND IDEOMOTOR SLOWNESS. CONCERNING NEURO-IMAGING , PML WHITE MATTER LESIONS ARE FOCAL AND AT THE CORTICO-SUBCORTICAL JUNCTION, WHILE HIVL WHITE MATTER INVOLVEMENT IS DIFFUSE AND CENTRALLY CONFINED. EVENTUALLY SURVIVAL IS LOWER IN PML THAN IN HIVL. DISCUSSION:THE ABOVE MENTIONED DISTINGUISHING CLINICAL CRITERIA COULD HELP , AT THE BEGINNING OF THE NEUROLOGICAL DISEASE, TO ACHIEVE A CORRECT DIAGNOSIS AND THEN A TIMELY THERAPEUTICAL APPROACH.

in campo neuro-AIDS la diagnosi differenziale tra la PML e l'encefalopatia da HIV sembra essere abbastanza definita. tuttavia quando la forma di encefalopatia da virus HIV si manifesta nella variante HIVL (leucoencefalopatia da HIV) molto frequentemente nelle fasi iniziali della malattia neurologica si evidenziano difficoltà di diagnosi differenziale principalmente con la PML. Obiettivi: lo studio si propone di identificare criteri di diagnosi differenziale tra PML e HIVL. Metodi: sono stati valutati i profili neurologici, neuroradiologici e infettivologici di soggetti con diagnosi anatomopatologica di PML e HIVL, senza presenza di coinfezioni cerebrali. Risultati. i soggetti inclusi nello studio sono risultati essere 10 con PML e 9 con HIVL. da un punto di vista clinico la PML ha un esordio subacuto. HIVL sucronico; la PML presenta prevalentemente deficit neurologici di tipo corticale mentre HIVL prevalentemente di tipo sottocorticale. dal punto di vista neuropsicologico la PML presenta deficit prevalentemente fasici, la HIVL deficit mnesici con rallentamento ideo-motorio. radiologicamente la PML presenta una sofferenza focale della sostanza bianca periferica mentre in HIVL vi è un diffuso coinvolgimento della sostanza bianca centrale. la sopravvivenza in PML risulta inferiore rispetto a HIVL. discussione. l'utilizzo dei suddetti criteri clinici nella fase iniziali della patologia cerebrale può costituire un ausilio per un corretto approccio diagnostico ed un tempestivo intervento terapeutico.

Grassi, M., Clerici, F., Perin, C., Boldorini, R., Borella, M., Nebuloni, E., et al. (1997). Leucoencefalopatia multifocale (PML) e leucoencefalopatia da HIV (HIVL): criteri clinici di diagnosi differenziale. GIORNALE ITALIANO DI MALATTIE INFETTIVE, 3(2), 94-100.

Leucoencefalopatia multifocale (PML) e leucoencefalopatia da HIV (HIVL): criteri clinici di diagnosi differenziale

PERIN, CECILIA;
1997

Abstract

IN NEURO--AIDS FILED THE DIFFERENTIAL DIAGNOSIS BETWEEN PML AND HIV ENCEPHALOPATHY SEEM QUITE DEFINITE. NEVERTHELESS SOME DIFFICULTIES ARISE, MAINLY AT THE BEGINNING OF THE DISEASE, WHEN HIV ENCEPHALOPATHY MANIFESTS ITSELF AS HIV LEUKOENCEPHALOPATHY (HIVL). THE PRESENT STUDY AIMS TO IDENTIFY SOM E DISTINGUISHING CRITERIA BETWEEN PML AND HIVL. METHODS: SUBJECTS WITH PATHOLOGICALLY PROVED PML OR HIVL WITHOUT CEREBRAL COINFECTIONS WERE NEUROLOGICALLY , NEURORADIOLOGICALLY AND IMMUNOLOGICALLY EVALUATED. RESULTS: 10 PATIENTS WERE AFFECTED BY PML WHILE 9 WERE AFFECTED BY HIVL. FROM A CLINICAL POINT OF VIEW PML ONSET IS SUBACUTE WHILE HIVL ONE IS INSIDIOUS; PML IS CHARACTERIZED BY NEUROLOGICAL SIGNS OF CORTICAL INCOLVEMENT WHILE HIVL NEUROLOGICAL DEFICITS ARE MAINLY SUBCORTICAL. FROM A NEUROPSYCHOLOGICAL POINT OF VIEW PML PRESENTS MAINLY LANGUAGE DEFICITS , WHILE HIVL PATIENTS HAVE MEMORY DEFICITS AND IDEOMOTOR SLOWNESS. CONCERNING NEURO-IMAGING , PML WHITE MATTER LESIONS ARE FOCAL AND AT THE CORTICO-SUBCORTICAL JUNCTION, WHILE HIVL WHITE MATTER INVOLVEMENT IS DIFFUSE AND CENTRALLY CONFINED. EVENTUALLY SURVIVAL IS LOWER IN PML THAN IN HIVL. DISCUSSION:THE ABOVE MENTIONED DISTINGUISHING CLINICAL CRITERIA COULD HELP , AT THE BEGINNING OF THE NEUROLOGICAL DISEASE, TO ACHIEVE A CORRECT DIAGNOSIS AND THEN A TIMELY THERAPEUTICAL APPROACH.
Articolo in rivista - Articolo scientifico
Acquired Immunodeficiency Syndrome(AIDS), Human Immunodeficiency Virus Leukoencephalopathy (HIVL), Progressive Multifocal Leukoencephalopathy (PML) Demyelinating Disease
sindrome da immunodeficienza acquisita(AIDS), leucoencefalopatia da virus dell'immunodeficienza umana (HIVL), leucoencefalopatia multifocale progressiva (PML), malattia demielinizzante
English
Italian
1997
3
2
94
100
none
Grassi, M., Clerici, F., Perin, C., Boldorini, R., Borella, M., Nebuloni, E., et al. (1997). Leucoencefalopatia multifocale (PML) e leucoencefalopatia da HIV (HIVL): criteri clinici di diagnosi differenziale. GIORNALE ITALIANO DI MALATTIE INFETTIVE, 3(2), 94-100.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/35036
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