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NEUROLOGY 1991;41:105
© 1991 American Academy of Neurology

Fulminating multiple sclerosis-like leukoencephalopathy revealing human immunodeficiency virus infection

F. Gray, MD, PhD, L. Chimelli, MD, PhD, M. Mohr, MD, P. Clavelou, MD, F. Scaravilli, MD, PhD and J. Poirier, MD, PhD

Département de Pathologie (Neuropathologie) (Drs. Gray and Poirier), Hôpital Henri Mondor, Créteil; Département de Neurosciences Médicales (Drs. Gray and Poirier), Faculté de Médecine de Créteil. Université Paris XII, Créteil; Institut de Pathologie (Dr. Mohr), Faculté de Médecine, Strasbourg; Service de Neurologie (Dr. Clavelou), Hôpital Fontmaure, Chamalières, France; Departamento de Patologia (Dr. Chimelli). Hospital Antônio Pedro Niteroi, Brazil; and the Department of Neuropathology (Dr. Scaravilli), Institute of Neurology, London, UK.

A 66-year-old French homosexual man and a 42-year-old Brazilian man with no known risk factors for HIV infection developed headaches, asthenia, and neurologic episodes of abrupt onset. CT showed multiple hypodense, nonenhancing lesions. Serology for HIV was positive. They died respectively 2 months and 1 month after onset of the illnesses. Autopsy in both cases showed multiple, well-demarcated, demyelinating foci in the white matter of the cerebral hemispheres, brainstem, and cerebellum with histologic features characteristic of recent plaques of multiple sclerosis. There were no multinucleated giant cells or microglial nodules. Immunostaining for HIV was negative. Although a random coincidence of MS and HIV infection cannot be ruled out, the close temporal relationship between the 2 disorders suggests a possible etiologic association.

Address correspondence and reprint requests to Docteur Françoise Gray, Département de Pathologie (Neuropathologie). Hôpital Henri Mondor, 94010 Crete il Cedex, France.

Supported in part by a grant from Agence Nationale de Recherches sur le SIDA to Doctor Gray.

Received April 16,1990. Accepted for publication in final form June 12, 1990.




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