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Advisor(s)
Abstract(s)
Os doentes com infecção VIH têm maior risco de AVC, do que os não infectados, sendo o VIH um factor independente preditor de isquemia. É neste contexto, que se apresenta o caso clínico de uma jovem com infecção VIH. Não obstante a doente em causa nunca ter tido sida, realizar terapêutica anti-retroviral de longa data e ter carga viral nula, tem sofrido AVC isquémicos como complicação do VIH. Far-se-á uma discussão do caso, enquadrando-o num dos algoritmos propostos na literatura, nomeadamente num quadro de aneurismas intracranianos, decorrentes de numa vasculopatia não aterosclerótica associada ao VIH. Quanto à abordagem, no caso reportado o plano passou pela manutenção da terapêutica anti-retroviral e controlo dos factores de risco cardiovascular. A doente ficou com seguimento na consulta de Neurologia, para despistar novas manifestações neurológicas, recorrendo também à imagiologia seriada, a fim de perceber a evolução e o grau de comprometimento do sistema vascular.
The patients with HIV infection present a higher risk of having stroke, than those not infected, provided that HIV function as an independent predictor factor of ischemia. In this regard, it is presented the clinical report of a young woman, infected with HIV. Who, regardless of never having had AIDS, being under the correct antiretroviral therapy for many years, and having a null viral count, developed ischemic strokes as a complication of HIV. It will be presented a discussion on the subject, framing the reported case in an algorithm proposed by the literature, namely a case of intracranial aneurysms, arising from an HIVassociated non-atherosclerotic vasculopathy. The proposed management was to continue the antiretroviral therapy, control the cardiovascular risk factors and schedule Neurology appointments to do the neuro-imaging follow-up.
The patients with HIV infection present a higher risk of having stroke, than those not infected, provided that HIV function as an independent predictor factor of ischemia. In this regard, it is presented the clinical report of a young woman, infected with HIV. Who, regardless of never having had AIDS, being under the correct antiretroviral therapy for many years, and having a null viral count, developed ischemic strokes as a complication of HIV. It will be presented a discussion on the subject, framing the reported case in an algorithm proposed by the literature, namely a case of intracranial aneurysms, arising from an HIVassociated non-atherosclerotic vasculopathy. The proposed management was to continue the antiretroviral therapy, control the cardiovascular risk factors and schedule Neurology appointments to do the neuro-imaging follow-up.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Keywords
AVC VIH Vasculite Aneurismas Neurologia