1. Clinical aspects of the AIDS dementia complex in relation to histopathological and immunohistochemical variables
- Author
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M Moroni, Monica Borella, M Grassi, Manuela Nebuloni, F Clerici, Luca Vago, Alfonso Mangoni, and Cecilia Perin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,AIDS Dementia Complex ,Settore MED/17 - Malattie Infettive ,Autopsy ,Neurological examination ,Settore MED/08 - Anatomia Patologica ,Central nervous system disease ,White matter ,Myelin ,Immunopathology ,medicine ,Dementia ,Humans ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Immunohistochemistry ,medicine.anatomical_structure ,Neurology ,Histopathology ,Female ,Settore MED/26 - Neurologia ,Neurology (clinical) ,business - Abstract
To correlate cerebral histopathological and immunohistochemical changes in the neuroclinical features of the AIDS dementia complex (ADC), autopsy results of 28 ADC patients were related, in a retrospective analysis, to scores on a standardised neurological examination performed at neurologic onset. From a histopathological point of view, the cases were classified as follows: 9 cases of HIV leucoencephalopathy (HIVL; diffuse myelin damage and rare microglial nodules), 7 cases of HIV encephalitis (HIVE; several microglial nodules and no myelin damage) and 12 cases of mixed HIVL and HIVE (HIVL-E). The groups differed significantly with respect to symptoms and CD4 count at neurologic onset, survival and neurological impairment. Immunohistochemically, the interstitial component (p24-positive cells scattered singly within the white matter) was significantly more prevalent in HIVL, and the micronodular component (p24-positive cells confined within microglial nodules) in HIVE. Neurological damage was worse in cases with a high prevalence of interstitial component or a low prevalence of micronodular component. HIVE, HIVL and HIVL-E are distinct clinical forms of ADC. Neurological impairment is related to white matter damage.
- Published
- 2002