Stambuk D, Singh S, Gazzard B; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 265 (abstract no. M.B.P.264).
St. Stephen's Hospital, London, England
CASE PRESENTATION: A 52 year old homosexual HIV+ve patient presented with sudden onset headache, dysphasia and blurred vision. He had a low grade pyrexia, right sided upper motor neurone 7th nerve palsy and left sided homonymous hemianopia. Brain CT scan showed multiple localized frontal, occipital, temporal and parietal lobe (left greater than right) cystic enhancing lesions suggestive of brain toxoplasma infection. He responded very well to treatment with Fansidar (two tablets b.d.), his signs and symptoms disappeared and he was discharged on maintenance Fansidar at a dose of one tablet every alternate day. Six weeks following the beginning of his brain infection he developed polydipsia and polyuria. Diabetes insipidus was confirmed with normal blood glucose, urine osmolalities never exceeding 172 mmo1/L and plasma osmolalities of over 300 mmo1/L. In spite of clear evidence of hypothalmic dysfunction his anterior pituitary function was normal with a good cortisol response to hypoglycemia, normal T4 (82 nmo1/L), prolactin (574 u/L) and normal responses of TSH, LH and FSH to their respective releasing factors. Treatment with DDAVP resulted in rapid resolution of diabetic symptoms. CONCLUSIONS: Neurogenic diabetes insipidus can follow cerebral toxoplasmosis in AIDS patients.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Brain
- Deamino Arginine Vasopressin
- Diabetes Insipidus
- Diabetes Insipidus, Neurogenic
- Disease Progression
- HIV Seropositivity
- Hemianopsia
- Humans
- Polyuria
- Pyrimethamine
- Toxoplasmosis, Cerebral
- sulfadoxine-pyrimethamine
Other ID:
UI: 102177118
From Meeting Abstracts