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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(02): 180
DOI: 10.1590/0004-282X20150173
IMAGES IN NEUROLOGY

Marchiafava-Bignami disease in an AIDS patient

Doença de Marchiafava-Bignami em um paciente com AIDS
Marcus Vinicius Pinto
1   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Neurologia, Rio de Janeiro RJ, Brazil;
,
André Bon
2   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brazil;
,
Valéria Carvalho Costa
2   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Doenças Infecciosas e Parasitárias, Rio de Janeiro RJ, Brazil;
,
Fábio Noro
3   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Radiologia, Rio de Janeiro RJ, Brazil.
,
Marco Antçnio Lima
1   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Departamento de Neurologia, Rio de Janeiro RJ, Brazil;
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A 40 year-old alcoholic man with AIDS developed acute encephalopathy and fever. Brain MRI showed a diffuse corpus callosum(CC) and periventricular white matter demyelinating lesions ([Figure]), suggestive of Marchiafava-Bignami disease (MBD). CD4 T lymphocyte count was 2/mm3, HIV viral load was 750000/mm3. CSF analysis was normal. Parenteral B vitamins were started with rapid improvement.

Zoom Image
Figure (A) Axial FLAIR image shows high signal intensity in anterior and posterior portions of the Corpus Callosum (white arrows) and periventricular white matter. (B) Sagital T1-weighted image shows low signal intensity along the entire lenght of the Corpus Callosum (white arrow).

MBD is metabolic disease characterized by demyelination of the CC, which occurs in severe alcoholism and malnourished states[1], rarely associated with AIDS. The main differential diagnosis of CC lesions are multiple sclerosis, lymphoma, viral encephalitis and stroke[2].

MBD must always be considered in alcoholics with encephalopathy despite of their immune status.


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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Hillbom M, Saloheimo P, Fujioka S, Wszolek ZK, Juvela S, Leone MA. Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases. J Neurol Neurosurg Psychiatry. 2014;85(2):168-73. doi:10.1136/jnnp-2013-305979
  • 2 Renard D, Castelnovo G, Campello C, Bouly S, Le Floch A, Trouvenot E et al. An MRI review of acquired corpus callosum lesions. J Neurol Neurosurg Psychiatry. 2014;85(9):1041-8. doi:10.1136/jnnp-2013-307072

Address for correspondence

Marcus Vinicius Pinto
Departamento de Neurologia, Hospital Universitário Clementino Fraga Filho; Avenida Brigadeiro Trompowiski, s/n; 21941-590 Rio de Janeiro RJ
Brasil   

Publication History

Received: 23 June 2015

Accepted: 14 September 2015

Article published online:
06 September 2023

© 2015. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Hillbom M, Saloheimo P, Fujioka S, Wszolek ZK, Juvela S, Leone MA. Diagnosis and management of Marchiafava-Bignami disease: a review of CT/MRI confirmed cases. J Neurol Neurosurg Psychiatry. 2014;85(2):168-73. doi:10.1136/jnnp-2013-305979
  • 2 Renard D, Castelnovo G, Campello C, Bouly S, Le Floch A, Trouvenot E et al. An MRI review of acquired corpus callosum lesions. J Neurol Neurosurg Psychiatry. 2014;85(9):1041-8. doi:10.1136/jnnp-2013-307072

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Zoom Image
Figure (A) Axial FLAIR image shows high signal intensity in anterior and posterior portions of the Corpus Callosum (white arrows) and periventricular white matter. (B) Sagital T1-weighted image shows low signal intensity along the entire lenght of the Corpus Callosum (white arrow).