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M94A2891.TXT
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1994-10-25
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Document 2891
DOCN M94A2891
TI Delayed PML diagnosis and d4T treatment.
DT 9412
AU Lutz B; Mogabgab W; Santos M; Combs K; New Orleans Health Department,
Owen Home Infusion, La.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):201 (abstract no. PB0234). Unique
Identifier : AIDSLINE ICA10/94369684
AB OBJECTIVE: To describe the clinical course of progressive multifocal
leukoencephalopathy (PML) in a patient taking stavudine (d4T). METHODS:
Single patient case report. RESULTS: After beginning therapy with d4T, a
patient with advanced HIV disease developed symptoms subsequently
diagnosed as an adjustment disorder and possible hysteria. After seven
months of d4T, the patient suspected an adverse drug reaction and
stopped d4T. An MRI at that time showed changes consistent with
extensive PML. After learning that his symptomatology was consistent
with a chronic opportunistic viral infection, his response to
psychotropic medications improved. DISCUSSION AND CONCLUSIONS: 1.
Organic disorders can cause diverse psychiatric manifestations
especially in advanced HIV disease. 2. The diagnosis of even untreatable
organic disease often helps a patient cope with increasing disabilities.
3. Headache, confusion, and toxic peripheral neuropathy are adverse
effects of d4T which crosses the blood-brain barrier. Can d4T also
initiate or aggravate a toxic central neuropathy? What effect does d4T
have on the natural history of PML?
DE Adaptation, Psychological Adjustment Disorders/*DIAGNOSIS AIDS-Related
Opportunistic Infections/DIAGNOSIS/*DRUG THERAPY/ PSYCHOLOGY Case
Report Diagnostic Errors Human Hysteria/*DIAGNOSIS HIV
Infections/DRUG THERAPY Leukoencephalopathy, Progressive
Multifocal/*DIAGNOSIS/DRUG THERAPY/PSYCHOLOGY Magnetic Resonance
Imaging Male Stavudine/*THERAPEUTIC USE Time Factors MEETING
ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).