Abstract
We report a case of AIDS with remarkable symptoms of central nervous system. The patient was a 40-year-old man. Route of infection of HIV is unknown. He had dementia, left hemiplegia, bulbar palsy, progressed to rigid decorticate posture and died of respiratory arrest due to involvement of the brain stem, despite of treatment including use of 3'-azido-2', 3'-dideoxythymidine (AZT). Magnetic resonance (MR) images showed progressive cerebral atrophy and a diffuse high signal intensity area of cerebral white matter on T2-weighted MR images, suggesting the diagnosis of HIV-induced encephalopathy. Beta-2-microglobulin concentration in the cerebrospinal fluid was high. p 24 band was gradually decreased in the course of time, which was revealed by Western blot analysis. In autopsy, marked atrophy of systemic lymphapparatus and marked decrease of CD 4 positive T cells in these tissues were found. Craniotomy was not allowed.