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27 October 2008

Chronic inflammation causing spinal cord compression in human immunodeficiency virus infection

Giovanni Grasso, Francesco Meli, Francesca Graziano, Vita Stagno, Pietro Imbruce, Ada Maria Florena, Rosario Maugeri, Domenico Gerardo Iacopino

Med Sci Monit 2008; 14(11): CS134-137 :: ID: 869430

Abstract

Background: The incidence of central nervous system involvement has increased in the setting of acquired immune deficiency syndrome (AIDS). Although rarely reported, spinal cord compression, in the setting of AIDS, has been associated with primary lymphoma or opportunistic infections.
Case Report: The authors describe the case of a young man who was admitted to our institution with rapid and progressive paraplegia. Imaging studies revealed an extramedullary lesion compressing the spinal cord spanning 3 thoracic levels. Surgical treatment was performed, and the compressing process completely excised. Histologic examination of the lesion showed a chronic inflammatory tissue with many necrotic areas without signs of infection or lymphoma. The patient progressively regained normal strength in his legs and was discharged home.
Conclusions: In patients with HIV, chronic inflammation can lead to a lesion that compresses the spinal cord and should be considered in the differential diagnosis. Knowledge of this entity gains importance with the increasing incidence of HIV because timely excision can restore neurologic deficits. This condition may be considered a new clinical entity, the true incidence of which will be established using the diagnostic protocols provided and further case reports.

Keywords: Lymphoma, AIDS-Related -- diagnosis, Spinal Cord Compression, Chronic Disease, HIV Infections - pathology, Inflammation - pathology, Magnetic Resonance Imaging, Spinal Cord Compression - surgery

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750