Patient Case - AIDS Complicated Leukemia and Myelatrophy

Case history and clinical manifestations

It is a case of AIDS definitely diagnosed by CDC, a female aged 32 years, who had pathological diagnosis of leukemia by bone marrow puncture in the year of 2005 and had intermittent fever, unclear consciousness, right facial paralysis, obstructed movement of both upper extremities and paraplegia of both lower extremities. The total white cells were 54 cells/μl, WBC was 3.2×109/L, and glutamicpyruvic transaminase (GPT) level was 56u/μl. Her brain MR imaging demonstrated cerebral atrophy and her spinal cord MR imaging demonstrated myelatrophy.

Imaging demonstrations

Fig. 3-5-1 A,B. Sagittal MR imaging demonstrating thinning of thoracic spinal cord, extended spinal central canal and widened subarachnoid space.

Diagnosis

AIDS complicated leukemia and myelatrophy.

Discussion

This case of young female AIDS patient has manifestations of progressive functional disturbance of extremities. The chief pathological changes of myelatrophy is thinning of spinal cord. Ischemia of AIDS patients is a chronic progressive course due to vasculo-philia nature of HIV for its invasion to supplying arteries of spinal cord, endothelium granuloma of supplying arteries, vascular cavity stenosis, ischemia of spinal cord and finally myelatrophy. Myelatrophy of non-AIDS patients have manifestations of lateral sclerosis of muscular atrophy, multiple sclerosis, vascular malformation, occlusion of anterior spinal artery, spinal cord trauma, myelitis and parasitic infection.