Treatment Challenges for Inflammatory Demyelinating Polyneuropathy in the Setting of Acute Retroviral Syndrome: Case Report and Review of the Literature
David A Lindholm, Tatjana P Calvano, Natascha M Minidis, Thomas J Bayuk, Heather C Yun and Jason F Okulicz*
San Antonio Military Medical Center, Fort Sam Houston, Texas, USA
- *Corresponding Author:
- Jason F Okulicz
Infectious Disease (MCHE-MDI)
San Antonio Military Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, Texas 78234, USA
E-mail: [email protected]
Received Date: August 30, 2013; Accepted Date: November 12, 2013; Published Date: November 17, 2013
Citation: Lindholm DA, Calvano TP, Minidis NM, Bayuk TJ, Yun HC, et al. (2013) Treatment Challenges for Inflammatory Demyelinating Polyneuropathy in the Setting of Acute Retroviral Syndrome: Case Report and Review of the Literature. J AIDS Clin Res 4:262. doi:10.4172/2155-6113.1000262
Copyright: © 2013 Lindholm DA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This is a case of a 20-year-old male with acute retroviral syndrome and concurrent acute inflammatory demyelinating polyneuropathy (IDP) progressing to chronic IDP. Whereas the patient followed a relapsing and remitting course prior to the initiation of antiretroviral therapy (ART), he demonstrated gradual and sustained clinical improvement in the ten months of follow-up after ART was combined with chronic corticosteroids and intermittent plasmapheresis. This case presents and addresses multiple challenges for the treatment of IDP in the setting of acute HIV infection to include: timing of initiation and selection of appropriate ART, the potential risk for immune reconstitution inflammatory syndrome, ART initiation in the setting of severe gastroparesis with jejunostomy placement, and the effect of plasmapheresis on the levels of antiretroviral therapy.