1991 Volume 14 Issue 2 Pages 216-223
A 36 year-old man was admitted because of diplopia and decreased memory. He had been homosexual since 22 years old. Before this admission, he had already presented symptoms of immunodeficiency, such as viral and fungal pneumonia, oral candidiasis and pneumocystis carinii pneumonia. A positive anti-human immunodeficiency virus (HIV) antibody was confirmed by immunofluorescence assay.
On admission, he had typical symptoms of acquired immunodeficiency syndrome (AIDS) related dementia complex, including decreased memory, the difficulty to concentrate, apathy and psychomotor retardation. Neurological findings revealed the right abducens paralysis, defect of temporal visual field and bilateral plantar dysesthesia. Ophthalmoscopic examination showed degenerative change in the right nasal retina.
Immunological findings demonstrated severe immunodeficiency: CD4 1.6% (3/mm3), CD4/CD8=0.03, decreased mitogenic response (Phytohemagglutinin 3, 326cpm, Concanavalin-A 821cpm, Control 275cpm). Progressive brain atrophy was disclosed with computed tomography. Decreased perfusion in whole brain especially in parietal and occipital lobes was displayed on brain perfusion scintigram. Electroencephalography showed the sleeping wave.
Various therapeutic agents including azidothymidine (AZT), γ-globulin, glycyrrhizin, interferon α and neurotropin were not effective. He died of respiratory arrest due to cytomegalovirus pneumonia or damage of central nervous system.
During the course of illness, he also presented eosinophilia, polyclonal gammopathy, thrombocytopenia and hemolytic anemia.
