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Dysphagia in relation to HIV

Jan 3, 2010

I was diagnosed with HIV 7 months ago and at that time my CD4=68 and VL=129K. I started ARV immediately and my current CD4=164 and VL=undetectable. About 6 months before Dx, I was showing signs of thrombocytopenia, so my hematologist put me on prednisone, first 20mg/daily then up to 40mg/daily. When I went to 40mg/daily, I experienced chronic hand tremors, involuntary body shakes and severe random dysphagia. After 3 months of being on prednisone I was taken off (by the way the prednisone didn't really help my platelet count) and the first two symptoms went away but every day I still experience this dysphagia. It will come on as an acute attack at random times during the day. It is accompanied with a severe ill feeling and I feel that it must have something to do with HIV and the nervous system. I was tested for thrush and it was not the cause. My neurologist has tested for Myasthenia Gravis antibodies and the test has come back negative. She has prescribed mestinon which seems to help a little but I still have daily episodes. My GI doctor has done an endoscopy and esophageal manometry and has diagnosed HLES but nothing can explain this chronic dysphagia. I thought I would post this to see if you have any other HIV patients who experience the same symptoms and what this condition could be. I appreciate your opinion.

Response from Dr. Holodniy

Sounds like you have the right specialists addressing this problem. Usually there is an obvious cause for this kind of problem. I assume you have also had a CT scan or some other kind of imaging study of the neck and chest to rule out extrinsic compression from a mass or something else that might be causing your symptoms.

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