Guillain-Barré syndrome spectrum as manifestation of HIV-related immune reconstitution inflammatory syndrome: case report and literature review

• Autor(a) principal: Vidal,José E.
• Data de Publicação: 2022
• Outros Autores: Guedes,Bruno F., Gomes,Hélio R., Mendonça,Rodrigo Holanda
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Brazilian Journal of Infectious Diseases
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702022000300400
• topic: Peripheral neuropathy; Guillain-Barré syndrome; HIV-1; Immune reconstitution inflammatory syndrome

ABSTRACT A 34-year-old man presented with a history of 21-days of gait unsteadiness and diplopia. Ten days before presentation, he developed limb weakness and in the last three days reduced consciousness. HIV infection was diagnosed three months ago (CD4+ = 160 cells/ mm3; viral load HIV-1 = 144.000 copies/mL), and antiretroviral therapy was initiated. Impaired consciousness, ophthalmoplegia, limb weakness, ataxia, areflexia, and Babinskys sign were noted. At that moment, CD4+ count was 372 cells/mm 3 and viral load HIV-1 < 50 copies/mL. The clinical, laboratory and neurophysiological findings suggest overlapping Guillain-Barré syndrome (GBS) and Bickerstaff brainstem encephalitis as manifestation of HIV-related immune reconstitution inflammatory syndrome (IRIS). Here, we review and discuss 7 cases (including the present report) of GBS spectrum as manifestation of HIV-related IRIS.