Journal of Pediatric Neurosciences
CASE REPORT
Year
: 2014  |  Volume : 9  |  Issue : 2  |  Page : 150--153

Acute disseminated encephalomyelitis: Extremely rare presentation of pediatric human immunodeficiency virus infection


Kailash Chandra Patra, Mukund S Shirolkar, Vaishali R Ghane 
 Department of Pediatrics, ESI PGIMSR, ESIC Model Hospital, Andheri, Mumbai, Maharashtra, India

Correspondence Address:
Kailash Chandra Patra
1101 Gloriosa Apartment, Agar Bazar, Dadar, Mumbai - 400 028, Maharashtra
India

Acquired human immunodeficiency virus (HIV) infection in a 10-year-old child, presenting with monoparesis, progressing to triplegia over 4 weeks is an extremely rare feature. The child had left upper motor neurone facial palsy with left hemiplegia, paralyzed right lower limb, grade zero power, exaggerated deep tendon reflexes and bilateral extensor plantars. Child tested positive for HIV by ELISA. CD3 + absolute count was 431. CD3 + CD4 count was 28, and CD45 absolute count was 478. Magnetic resonance imaging of brain and spine showed multiple ill-defined foci of hyperintensity in white matter suggestive of ADEM. Acute demyelinating encephalomyelitis (ADEM) is an extremely rare presenting feature of perinatally acquired HIV infection in paediatrics. Clinically child remained same even with methylprednisolone, intravenous immunoglobulin, antituberculosis therapy, trimethoprim-sulfamethoxazole prophylaxis and supportive therapy. Child had sudden clinical deterioration and death before antiretroviral therapy could be initiated. This case emphasizes that pediatricians and neurophysicians should suspect HIV as an etiology of ADEM in cases with atypical clinical presentation and social risk factors, in spite of its very rare occurrence.


How to cite this article:
Patra KC, Shirolkar MS, Ghane VR. Acute disseminated encephalomyelitis: Extremely rare presentation of pediatric human immunodeficiency virus infection.J Pediatr Neurosci 2014;9:150-153


How to cite this URL:
Patra KC, Shirolkar MS, Ghane VR. Acute disseminated encephalomyelitis: Extremely rare presentation of pediatric human immunodeficiency virus infection. J Pediatr Neurosci [serial online] 2014 [cited 2020 Feb 25 ];9:150-153
Available from: http://www.pediatricneurosciences.com/article.asp?issn=1817-1745;year=2014;volume=9;issue=2;spage=150;epage=153;aulast=Patra;type=0