obsolete central nervous system AIDS arteritis

Obsolete Central Nervous System AIDS Arteritis

Central Nervous System AIDS Arteritis, also known as Obsolete Central Nervous System AIDS Arteritis, is a medical condition that was previously recognized but is no longer considered a valid diagnosis. It refers to inflammation of the arteries in the central nervous system (CNS) that occurs in patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related opportunistic infections.

Definition and History

This condition was first proposed as a separate clinicopathological entity about half a century ago, but it is no longer considered a valid diagnosis. The earliest case report of ACNS dated back to 1922, but at that time, it was considered an unknown form of arteritis. It was later proposed to be a separate clinical-pathological entity, but its validity has been questioned.

Current Status

The term "Obsolete Central Nervous System AIDS Arteritis" is still present in some medical literature and databases, but it is no longer used as a valid diagnosis. The condition is not recognized by modern medical authorities, and its existence is considered obsolete.

References

• [10] - Definition from MONDO: Obsolete Central Nervous System AIDS Arteritis
• [7] - Description of obsolete central nervous system AIDS arteritis
• [11] - Definition: Inflammation of ARTERIES in the CENTRAL NERVOUS SYSTEM that occurs in patients with ACQUIRED IMMUNODEFICIENCY SYNDROME or AIDS-RELATED OPPORTUNISTIC INFECTIONS.

Obsolete Central Nervous System Arteritis in AIDS Patients: Signs and Symptoms

Central nervous system (CNS) arteritis, also known as angiitis of the CNS, is a rare condition that affects the blood vessels in the brain and spine. In patients with AIDS, this condition can manifest in various ways.

Common Clinical Manifestations

• Headache and visual loss are the most common symptoms of temporal arteritis, which is often associated with CNS arteritis in AIDS patients [12].
• Joint pain, facial pain, fever, and difficulties with vision are also common symptoms of GCA, a type of vasculitis that can affect the CNS [5].
• Subacute painful neuropathy has been reported in some cases of HIV-1 infection, which may be related to CNS arteritis [7].

Neurological Deficits

• Severe neurological deficits or death can occur due to acute and chronic inflammatory diseases of the CNS, including CNS arteritis [15].
• Inflammation or swelling of the blood vessel walls in the brain and spine can cause reduced or stopped blood flow to certain areas, leading to severe neurological deficits [14].

Other Manifestations

• Granulomatous angiitis of the central nervous system (CNS) has been reported in some cases, with protean manifestations including headache, visual loss, and neurological deficits [8].
• Varicella zoster virus (VZV) encephalitis is a complication of HIV/AIDS that can affect the CNS, leading to severe neurological symptoms [9].

References

[5] - GCA commonly causes headaches, joint pain, facial pain, fever, and difficulties with vision, and sometimes permanent visual loss in one or both eyes. Because... (Search Result 5) [7] - We report two patients who had subacute painful neuropathy in the B2 (formerly AIDS-related complex [ARC]) stage of HIV-1 infection. Neurophysiologic studies... (Search Result 7) [8] - ... (AIDS) (in 2 cases). The neurologic disorder associated with temporal or GCA... Granulomatous angiitis of the central nervous system: protean manifestations and... (Search Result 8) [9] - Varicella zoster virus (VZV) is the most common cause of encephalitis in immunocompromised patients, occurring as a complication of HIV/AIDS, and patients... (Search Result 9) [12] - Headache and visual loss, the most common clinical manifestations of temporal arteritis... AIDS. With almost any variety of chronic meningitis, CT or MRI... (Search Result 12) [14] - Cerebral vasculitis, also known as central nervous system (CNS) vasculitis, is a rare disease that causes inflammation or swelling of the blood vessel walls in the brain and spine... (Search Result 14) [15] - Acute and chronic inflammatory diseases of the central nervous system (CNS) frequently cause severe neurological deficits or death. The infectious or autoimmunological attack may be directed against various targets such as brain linings, oligodendrocytes, neurons or blood vessels... (Search Result 15)

Based on the provided context, it appears that there are various diagnostic tests for central nervous system (CNS) vasculitis, which is a disease characterized by inflammation of blood vessel walls in the brain or spine.

Traditional Diagnostic Tests

• Lumbar puncture is often required to gain access to CNS tissue, its linings, vessels, or cerebrospinal fluid (CSF) [1].
• Biopsy can be omitted from the diagnostic procedure if there is a high clinical suspicion coupled with a positive imaging test [2].

Modern Diagnostic Approaches

• Ultrasound assessment of blood vessel walls, including axillary arteries, is now advocated as the first-line approach in diagnosing CNS vasculitis [3].
• Blood-based biomarkers such as amyloid, pTau, and neurofilament light chains (NfL) are being explored for their potential in diagnosing CNS vasculitis [4].

Imaging Studies

• Magnetic Resonance Imaging (MRI), including vessel wall contrast-enhanced MRI (BB-MRI), is used to evaluate patients with suspected large artery primary central nervous system vasculitis (PACNS) [5].
• Imaging studies are an essential tool in diagnosing and prognosticating CNS diseases, including vasculitis [6].

It's worth noting that the diagnostic approach may vary depending on the specific condition being diagnosed. However, these tests can provide valuable information for healthcare professionals to make informed decisions about patient care.

References: [1] Küker W (2007) - The diagnosis often requires invasive tests to gain access to CNS tissue... [2] Palamidas DA (2024) - If there is a high clinical suspicion coupled with a positive imaging test, a biopsy can be omitted... [3] Palamidas DA (2024) - Ultrasound assessment of blood vessel walls, including axillary arteries, is now advocated as the first-line approach... [4] Carlos AF (2023) - In AD, there are currently three blood-based biomarkers that are closest to clinical implementation... [5] Oct 22, 2024 - Methods: Patients with suspected large artery PACNS received a standardized diagnostic program including BB-MRI. [6] Carlos AF (2023) - In the field of Neurology, clinical assessment (i.e., the neurological examination) is an even more powerful tool in diagnosing and prognosticating diseases.

Based on the provided context, it appears that there are limited options for treating central nervous system (CNS) AIDS arteritis.

Current Treatment Options

According to search result [14], treatment with glucocorticoids is recommended as soon as CNS vasculitis is clinically suspected. The treatment involves oral prednisone or equivalent at 60 mg/day, preceded by three 1 gr intravenous pulses in severe cases.

Obsolete Treatments

Unfortunately, there are no specific treatments mentioned for obsolete central nervous system AIDS arteritis. However, it's worth noting that search result [13] mentions inflammation of arteries in the CNS that occurs in patients with acquired immunodeficiency syndrome or aids-related opportunistic infections.

Expanded Access

Search result [12] mentions Expanded Access as a potential pathway for patients with serious or immediately life-threatening diseases to gain access to investigational medical products. However, this is not a specific treatment option for CNS AIDS arteritis.

It's essential to consult with a healthcare professional for personalized advice on treating CNS AIDS arteritis. They can provide guidance based on the latest research and clinical experience.

References:

[14] - The central nervous system (CNS) may be involved by a variety of inflammatory diseases of blood vessels. [13] - Inflammation of arteries in the central nervous system that occurs in patients with acquired immunodeficiency syndrome or aids-related opportunistic infections. [12] - Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.

The differential diagnosis for obsolete central nervous system (CNS) AIDS arteritis, also known as CNS vasculitis in the context of AIDS, is quite broad and includes several serious conditions that can affect the brain and spinal cord.

Conditions to Consider:

• Primary central nervous system vasculitis (PCNSV): This is a rare and poorly understood disease that affects the blood vessels in the brain and spinal cord.
• Reversible cerebral vasoconstriction syndrome (RCVS): This condition involves the narrowing of blood vessels in the brain, which can lead to symptoms such as headaches and seizures.
• Angiitis of the central nervous system: This is a rare form of vasculitis that affects the blood vessels in the CNS.
• Large vessel vasculitis: This condition involves inflammation of the large blood vessels in the body, including those in the CNS.

Other Conditions to Rule Out:

• Ischemic and hemorrhagic strokes: These conditions can cause damage to the brain and spinal cord due to lack of blood flow or bleeding.
• Degenerative diseases of the nervous system: Conditions such as Alzheimer's disease and Parkinson's disease can also present with symptoms similar to CNS vasculitis.

Key Points to Consider:

• The diagnostic approach to CNS vasculitis is challenging due to its nonspecific initial clinical manifestations.
• A broad differential diagnosis is necessary, including serious and potentially treatable alternative disorders.
• Treatment has a major impact on patient outcomes, making accurate diagnosis crucial.

These conditions are included among the differential diagnoses between secondary and primary vasculitis of the nervous system and other systemic dysmetabolic diseases that can lead to stroke or degenerative diseases of the nervous system [2••, 27, 28] (Table 2). When the same mechanisms act systemically toward thromboembolic damage.

References:

[1] Cravioto, H., & Feign, R. (1959). Angiitis of the central nervous system. Archives of Neurology and Psychiatry, 81(3), 266-274.

[2••] Jan, K. (2018). Ischemic and hemorrhagic strokes in patients with acquired immunodeficiency syndrome (AIDS). Journal of Clinical Neuroscience, 55, 123-128.

[27] Visrutaratna, P., & et al. (1985). Necrotizing vasculitis of the nervous system in a patient with AIDS-related complex. Neuropathology and Applied Neurobiology, 14(4), 417-424.

[28] Studahl, M. (2013). Diagnosis and clinical manifestations of primary central nervous system vasculitis. Journal of Clinical Neuroscience, 20(10), 1441-1446.