Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 37 year old male developed fever for 20 days, along with headache, anorexia, malaise, sweating, pharyngitis, lymphadenopathy and splenomegaly. At this stage, Ag p24 was positive and anti HIV was negative. The patient recovered fully but 6 months later positive HIV titers were demonstrated by immunofluorescence and Western-blot. A retrospective diagnosis of acute retroviral syndrome was made. The difficult differential diagnosis with infectious mononucleosis, cytomegalovirus, measles, rubella, toxoplasmosis and influenza is discussed. Thus, anti HIV antigenemia should be investigated in any patient with a mononucleosis like syndrome belonging in a high risk group for AIDS, even if Paul-Bunnell-Davidson or IgG anti VCA-EB reactions are positive.
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PMID:[Acute retroviral syndrome]. 182 45

Zidovudine is approved for administration in doses given every 4 hours. Less frequent dosing has been used in many clinical trials, but the toxicity and efficacy of such regimens have not been formally compared with the approved regimen. In this multicenter, randomized, double-blind, controlled trial, the safety, tolerance and efficacy of 600 mg of zidovudine given daily in two or six divided doses were compared. Three hundred and twenty patients with a CD4 lymphocyte count < 250 cells/mm3 (mean, 104 cells/mm3) or a prior AIDS-defining illness were treated with zidovudine 100 mg every 4 hours (regimen A) or 300 mg every 12 hours (regimen B). Eighty-eight patients (56%) and 94 patients (58%), assigned to regimens A and B, respectively, completed the planned 48 weeks of treatment. Serious anemia (hemoglobin < or = 7.5 g/dl) occurred in 13% and 7% of patients treated with regimens A and B, respectively (difference, 6%, 95% confidence interval [CI], 2, 12%; p = .13). The mean duration of treatment and the frequency of neutropenia and symptomatic complaints including nausea and headache were similar in the two treatment groups. The number of patients experiencing a new opportunistic infection (18% versus 20% for regimens A and B, respectively), and the number of deaths (five in each group) did not differ significantly between groups. The effect of treatment on CD4 lymphocyte counts and HIV p24 antigenemia also was similar for both regimens. Zidovudine given at the more convenient dose of 300 mg twice daily has similar safety, and tolerance and appears to have similar efficacy to the currently approved regimen. Use of this regimen should help simplify the treatment of HIV disease.
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PMID:A comparative trial of zidovudine administered every four versus every twelve hours for the treatment of advanced HIV disease. 929 87

A 38-year-old homosexual male with AIDS suffered four neurological episodes including headaches, confusion, visual impairment, memory disturbances, and dysarthria which resolved spontaneously in a few days. He was admitted to hospital during a fifth episode. Neurological examination revealed a cerebellar syndrome. General examination was normal. CD4 count was 90. CSF contained two WBCs/mm(3) and 12.30 mg/dL protein. MRI revealed diffuse ill defined increased signal on T2-weighted images in the white matter. His condition worsened rapidly with vomiting and he died 1 month after admission. Neuropathological examination revealed diffuse brain oedema with ventricular compression, central diencephalic herniation and bilateral tonsilar herniation in the absence of a focal lesion. Microscopical examination revealed predominant involvement of the white matter with diffuse myelin pallor and massive perivascular dilatation containing an exudate expressing serum proteins and occasional macrophages. The same exudate was also diffuse in the leptomeninges. Parenchymal damage predominated around the perivascular spaces and included loosening of tissue, axonal damage with spheroids and reactive astrocytosis. There was no evidence of productive HIV encephalitis, no multinucleated giant cells; p24 immunostaining and RT-PCR for HIV genome were negative. There was neither significant inflammation nor microglial activation. In this illustrative case, the relapsing course of the neurological signs, the diffuse topography of the blood-brain barrier breakdown and the absence of local cause make it likely that the diffuse leak and axonal damage could be related to circulating factors.
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PMID:Acute, relapsing brain oedema with diffuse blood-brain barrier alteration and axonal damage in the acquired immunodeficiency syndrome. 971 86

A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission. HIV RNA was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.
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PMID:[Case of acute primary HIV infection with menigoencephalitis demonstrating high signal intensity of the bilateral globus pallidus in T2-weighted MRI]. 1801 20

A 32-year-old homosexual man was admitted because of acute headache, fever, and lymphoadenopathy. The neurological examination revealed nuchal rigidity and positive Kernig's sign. The cell count of cerebrospinal fluid (CSF) at the time of admission, however, was four per microliter and subsequently increased up to 31 per microliter in three days. The serum antibody for human immunodeficiency virus (HIV) was positive in ELISA and the cell number of CD4 positive population decreased to 280. The RT-PCR for HIV RNA was 7.6 x 10(5) copies per milliliter, which gradually decreased, leading to the diagnosis of meningitis due to HIV itself. The Western blotting for HIV antibodies were positive for p24, p40 and p55, whereas that for gp 41 was negative in serum and CSF, suggesting that the meningitis occurred during the seroconversion in this patient. We surmise that aseptic meningitis during HIV primary infection usually results in mild CSF pleocytosis and sometimes leads to even normocytosis shown as in this patient, probably because cellular immunity is temporally suppressed in acute HIV infection.
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PMID:[CSF normocytosis in meningitis due to primary infection of human immunodeficiency virus]. 1934 74