Abstract
In AIDS, pathology in the spinal contents usually follows that in the brain but is less frequent. Opportunistic infections are found in an average of 9.5% of spinal AIDS autopsies but in 54% of autopsies of the whole CNS. Necrotizing CMV radiculomyelitis is a rare (3.4% in spinal autopsies) but very characteristic opportunistic spinal lesion. The most prominent spinal cord disease in AIDS is vacuolar myelopathy, occurring in greatly differing frequencies according to different geographical areas, with a mean of about 22.5% in AIDS spinal cord autopsies. Its pathogenesis and clinicopathologic correlation need clarification; it appears to develop mainly in severely ill AIDS patients with significant viral load, advanced immunosuppression, and confounding metabolic imbalance.
MeSH terms
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AIDS-Related Opportunistic Infections / diagnosis
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AIDS-Related Opportunistic Infections / immunology
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AIDS-Related Opportunistic Infections / metabolism
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AIDS-Related Opportunistic Infections / pathology*
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Cytomegalovirus Infections / pathology
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Demyelinating Diseases / pathology
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Demyelinating Diseases / virology
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Disease Progression
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Herpesviridae Infections / pathology
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Humans
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Immune Tolerance
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Immunocompromised Host
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Mycoses / pathology
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Myelitis / microbiology
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Myelitis / pathology*
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Myelitis / virology
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Necrosis
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Radiculopathy / pathology
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Radiculopathy / virology
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Spinal Cord Diseases / immunology
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Spinal Cord Diseases / metabolism
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Spinal Cord Diseases / microbiology
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Spinal Cord Diseases / parasitology
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Spinal Cord Diseases / pathology*
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Spinal Cord Diseases / virology
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Toxoplasmosis / pathology
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Vacuoles / ultrastructure
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Viremia / virology