Susac’s syndrome as HIV-associated immune reconstitution inflammatory syndrome
1 Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
2 Unit of Neuroradiology, San Raffaele Scientific Institute, Milan, Italy
3 Department of Neurology, San Raffaele Scientific Institute, Milan, Italy
4 Department of Neurology, IRCCS, C. Mondino National Institute of Neurology, Pavia, Italy
5 Department of Neurology, IRCCS Neurologic Institute Carlo Besta Institute, Milan, Italy
AIDS Research and Therapy 2013, 10:22 doi:10.1186/1742-6405-10-22Published: 3 September 2013
Susac’s Syndrome (SS) is an autoimmune endotheliopathy of cerebral, retinal and cochlear arterioles. We report of an HIV-infected woman who developed a first SS episode following a spontaneous reduction of plasma viral load and several relapses six years later, following initiation of combined antiretroviral therapy (cART). Corticosteroids and intravenous immunoglobulins alone did not control the disease, which improved after combined treatment with acyclovir and ganciclovir. SS onset in HIV infection and relapses during cART-induced immune reconstitution are consistent with the dysimmune nature of the disease. The response to anti-herpes drugs suggests a viral contribute in this case of SS.