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Bilateral Holmes–Adie syndrome as an early manifestation of the HIV neuropathy

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Abstract

A 38-year-old HIV-1 infected woman affected with bilateral tonic pupils. Ophthalmologic examination confirmed Holmes–Adie syndrome (HAS), and peripheral distal polyneuropathy, orthostatic hypotension and leg hyperhidrosis were detected on further workup. The HAS can be either idiopathic or associated with neuropathy of various etiology (autoimmune, paraneoplastic and infectious). In our patient, the pupillotonia was the first and early symptom of hitherto unrecognized HIV neuropathy. HAS has been previously observed in association with syphilis, Lyme borreliosis, herpes simplex and parvovirus B19 infection. Our case is the first report of HAS in a case of HIV infection.

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Authors and Affiliations

  1. Department of Neurology, 2nd Medical Faculty, Charles University in Prague, Prague, Czech Republic

    Rudolf Cerny

  2. Department of Infectious and Tropical Diseases, First Faculty of Medicine, University Hospital Bulovka, Charles University in Prague, Prague, Czech Republic

    Hanus Rozsypal

  3. Department of Ophthalmology, University Hospital Bulovka, Prague, Czech Republic

    Pavel Kozner

  4. 1st Department of Infectious Diseases, 2nd Faculty of Medicine and Department of Infectious Diseases, Third Faculty of Medicine, Charles University in Prague, Budinova 2, 18081, Prague, Czech Republic

    Ladislav Machala

Authors
  1. Rudolf Cerny
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  2. Hanus Rozsypal
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  3. Pavel Kozner
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  4. Ladislav Machala
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Correspondence to Ladislav Machala.

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Cerny, R., Rozsypal, H., Kozner, P. et al. Bilateral Holmes–Adie syndrome as an early manifestation of the HIV neuropathy. Neurol Sci 31, 661–663 (2010). https://doi.org/10.1007/s10072-010-0355-9

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  • DOI: https://doi.org/10.1007/s10072-010-0355-9

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