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Case report: narcolepsy type 1 in an adolescent with HIV infection-coincidence or potential trigger?


Scherrer, Karin Sofia; Relly, Christa; Hackenberg, Annette; Berger, Christoph; Paioni, Paolo (2018). Case report: narcolepsy type 1 in an adolescent with HIV infection-coincidence or potential trigger? Medicine, 97(30):e11490.

Abstract

RATIONALE
Despite the acknowledged importance of environmental risk factors in the etiology of narcolepsy, there is little research on this topic. HIV as a trigger for narcolepsy has not been systematically investigated.
PATIENT CONCERNS
We describe a case of narcolepsy type 1 (NT1) in an adolescent with HIV infection presenting with increased daytime sleepiness and excessive weight gain.
DIAGNOSES
NT1 was diagnosed according to the criteria of the third edition of the International Classification of Sleep Disorders (ICSD-3).
INTERVENTIONS
Pharmacological treatment with methylphenidate.
OUTCOMES
Four months after initiation of methylphenidate therapy the increased daytime sleepiness improved and excessive weight gain stopped.
LESSONS
Diagnosis of NT1 can be challenging at disease onset and is often delayed, especially in the pediatric population, because symptoms usually evolve gradually. The case presented here raises the possibility that the HIV infection may play a role in the pathogenesis of NT1 serving as trigger for autoimmune-mediated destruction of hypocretin-secreting neurons.

Abstract

RATIONALE
Despite the acknowledged importance of environmental risk factors in the etiology of narcolepsy, there is little research on this topic. HIV as a trigger for narcolepsy has not been systematically investigated.
PATIENT CONCERNS
We describe a case of narcolepsy type 1 (NT1) in an adolescent with HIV infection presenting with increased daytime sleepiness and excessive weight gain.
DIAGNOSES
NT1 was diagnosed according to the criteria of the third edition of the International Classification of Sleep Disorders (ICSD-3).
INTERVENTIONS
Pharmacological treatment with methylphenidate.
OUTCOMES
Four months after initiation of methylphenidate therapy the increased daytime sleepiness improved and excessive weight gain stopped.
LESSONS
Diagnosis of NT1 can be challenging at disease onset and is often delayed, especially in the pediatric population, because symptoms usually evolve gradually. The case presented here raises the possibility that the HIV infection may play a role in the pathogenesis of NT1 serving as trigger for autoimmune-mediated destruction of hypocretin-secreting neurons.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2018
Deposited On:12 Sep 2018 14:38
Last Modified:24 Sep 2019 23:35
Publisher:Lippincott Williams & Wilkins
ISSN:0025-7974
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1097/MD.0000000000011490
PubMed ID:30045272

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