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M94A2910.TXT
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1994-10-25
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Document 2910
DOCN M94A2910
TI CMV polyradiculomyelitis in AIDS: 7 cases.
DT 9412
AU Jacomet C; Lebrette MG; De Montfort L; el Amrani M; Gozlan J; Girard PM;
Rozenbaum W; Hopital Rothschild, Paris, France.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):197 (abstract no. PB0217). Unique
Identifier : AIDSLINE ICA10/94369665
AB OBJECTIVE: To describe features of CMV polyradiculomyelitis. METHODS:
Retrospective chart analysis of 7 cases. RESULTS: Among 861 AIDS
patients (pts) from the same unit, 7 cases of CMV polyradiculomyelitis
were diagnosed from June 1991 to December 1993. It was the first
manifestation of AIDS in 2/7 cases. Mean duration of previous
antiretroviral therapy was 16 months. No previous CMV localization had
previously occurred. Progressive paraparesia developed in all patients
and was associated with lombar pain in 2/7 patients and with dysuria or
urinary retention in 5/7 patients. Mean CD4+ T lymphocyte count was
22/mm3 (3-44). CSF abnormalities were: mean hyperproteinorachia: 1.17
g/l (0.6-1.56), mean pleocytosis: 398/mm3 (9-1030) with 67%
polymorphonuclear leukocytes. CSF bacteriological cultures were negative
but CMV was cultured in 4/5 cases and CMV DNA detected by PCR in 5/5
cases. Mean duration of ganciclovir therapy (10 mg/kg/d) was 6.5 weeks
(5-11). Response to therapy (complete: 3 pts, partial: 3 pts and
unchanged: 1 pt) was related to early intervention. Undertreatment
analysis of CSF was done in 4 pts: CMV culture negativated in
Undertreatment analysis of CSF was done in 4 pts: CMV culture
negativated in 4/4 and PCR in 3/4. Under maintenance ganciclovir therapy
(5 mg/kg/d), 4/5 pts relapsed after a mean delay of 4.2 weeks and death
was related to the relapse in 3 patients. CONCLUSION: CMV
polyradiculomyelitis is a well-defined, recently described disease in
AIDS pts. CMV PCR appeared highly valuable diagnostic tool. Early
anti-CMV therapy is required; its best schedule remains to be
determined.
DE AIDS-Related Opportunistic Infections/BLOOD/CEREBROSPINAL FLUID/ DRUG
THERAPY/*MICROBIOLOGY Cytomegalovirus/ISOLATION & PURIF
*Cytomegalovirus Infections/BLOOD/CEREBROSPINAL FLUID/DRUG THERAPY
Ganciclovir/THERAPEUTIC USE Human Myelitis/BLOOD/CEREBROSPINAL
FLUID/DRUG THERAPY/*MICROBIOLOGY Polymerase Chain Reaction
Polyradiculitis/BLOOD/CEREBROSPINAL FLUID/DRUG THERAPY/ *MICROBIOLOGY
Recurrence Retrospective Studies MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).