Document 2891
 DOCN  M94A2891
 TI    Delayed PML diagnosis and d4T treatment.
 DT    9412
 AU    Lutz B; Mogabgab W; Santos M; Combs K; New Orleans Health Department,
       Owen Home Infusion, La.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):201 (abstract no. PB0234). Unique
       Identifier : AIDSLINE ICA10/94369684
 AB    OBJECTIVE: To describe the clinical course of progressive multifocal
       leukoencephalopathy (PML) in a patient taking stavudine (d4T). METHODS:
       Single patient case report. RESULTS: After beginning therapy with d4T, a
       patient with advanced HIV disease developed symptoms subsequently
       diagnosed as an adjustment disorder and possible hysteria. After seven
       months of d4T, the patient suspected an adverse drug reaction and
       stopped d4T. An MRI at that time showed changes consistent with
       extensive PML. After learning that his symptomatology was consistent
       with a chronic opportunistic viral infection, his response to
       psychotropic medications improved. DISCUSSION AND CONCLUSIONS: 1.
       Organic disorders can cause diverse psychiatric manifestations
       especially in advanced HIV disease. 2. The diagnosis of even untreatable
       organic disease often helps a patient cope with increasing disabilities.
       3. Headache, confusion, and toxic peripheral neuropathy are adverse
       effects of d4T which crosses the blood-brain barrier. Can d4T also
       initiate or aggravate a toxic central neuropathy? What effect does d4T
       have on the natural history of PML?
 DE    Adaptation, Psychological  Adjustment Disorders/*DIAGNOSIS  AIDS-Related
       Opportunistic Infections/DIAGNOSIS/*DRUG THERAPY/  PSYCHOLOGY  Case
       Report  Diagnostic Errors  Human  Hysteria/*DIAGNOSIS  HIV
       Infections/DRUG THERAPY  Leukoencephalopathy, Progressive
       Multifocal/*DIAGNOSIS/DRUG  THERAPY/PSYCHOLOGY  Magnetic Resonance
       Imaging  Male  Stavudine/*THERAPEUTIC USE  Time Factors  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).