Recurrent vacuolar myelopathy in HIV infection

Summary 

Objectives

Vacuolar myelopathy is the major cause of spinal cord disease in HIV-1 infection. However, the pathogenesis remains unclear. Diagnosis is mainly based on characteristic clinical symptoms in combination with characteristic MRI changes. Usually, it is a slowly progressive chronic disease affecting HIV-infected individuals with low CD4 T-cell counts.

Case

Here, we report an uncommon case of vacuolar myelopathy in an HIV-infected woman with recurrent clinical symptoms and MRI changes of vacuolar myelopathy and with a preserved CD4 T-cell count when symptoms occurred for the first time.

Conclusions

This is the first case, to show that vacuolar myelopathy can have relapsing–remitting clinical symptoms and MRI changes.

Keywords: Vacuolar myelopathy, HIV-1 infection, Myelopathy, HAART, Myelitis, Spinal cord disease