Summary
A peripheral nerve biopsy was performed in 15 patients with human immunodeficiency virus (HIV) infection and polyneuropathy. Two cases [1 asymptomatic, 1 AIDS-related complex (ARC)] presented with chronic inflammatory demyelinating polyneuropathy; there was 1 case (asymptomatic) of mononeuropathy multiplex and 12 cases (1 asymptomatic, 1 ARC, 10 AIDS) with distal symmetrical polyneuropathy. Epi- or endoneurial microvasculitis was observed in 6 cases. Electron microscopy showed that nerve fiber lesions were mainly axonal. Severe segmental demyelination was also present in both cases of chronic inflammatory demyelinating polyneuropathy, with characteristic features of active demyelination in one. Numerous plasmacytoid cells were found in the endoneurium in 4 patients. Tubuloreticular inclusions were present in endothelial cells in the 10 cases with AIDS but absent in the other patients. Direct immunopathological examination with anti-immunoglobulin sera was negative in all cases. HIV was evidenced by in situ hybridization in 2 AIDS patients; no Epstein-Barr virus or cytomegalovirus was detected.
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Bailey RO, Baltch AL, Venkatesh R, Singh JK, Bishop MB (1988) Sensory motor neuropathy associated with AIDS. Neurology 38:886–891
Behar R, Wiley C, McCutchan JA (1987) Cytomegalovirus polyradiculoneuropathy in acquired immune deficiency syndrome. Neurology 37:557–561
Budka H, Wiley CA, Kleihues P, Artigas J, Asbury AK, Cho ES, Cornblath DR, Dal Canto MC, de Girolami U, Dickson D, Epstein LG, Esiri MM, Giangaspero F, Gosztonyi G, Gray F, Griffin JW, Henin D, Iwasaki Y, Janssen RS, Johnson RT, Lantos PL, Lyman WD, McArthur JC; Nagashima K, Peress N, Petito CK, Price RW, Rhodes RH, Rosenblum M, Said G, Scaravilli F, Sharer LR, Vinters HV (1991) HIV-associated disease of the nervous system: review of nomenclature and proposal for neuropathology-based terminology. Brain Pathol 1:143–152
Chaunu MP, Ratinahirana H, Raphael M, Hénin D, Leport C, Brun-Vezinet F, Léger JM, Brunet P, Hauw JJ (1989) The spectrum of changes on 20 nerve biopsies in patients with HIV infection. Muscle Nerve 12:452–459
Cornblath DR, McArthur JC, Kennedy PGE, Witte AS, Griffin JW (1987) Inflammatory demyelinating peripheral neuropathies associated with human T-cell lymphotropic virus type III infection. Ann Neurol 21:32–40
Dalakas MC, Pezeshkpour GH (1988) Neuromuscular diseases associated with human immunodeficiency virus infection. Ann Neurol 23 [Suppl]: S38-S48
De la Monte SM, Gabuzda DH, Ho DD, Brown RH, Hedley-Whyte ET, Schooley RT, Hirsch MS, Bhan AK (1988) Peripheral neuropathy in the acquired immunodeficiency syndrome. Anneurol 23:485–492
De Vos R, de Wolf-Peeters C, Facchetti F, Desmet V (1990) Plasmacytoid monocytes in epithelioid cell granulomas: ultrastructural and immunoelectron microscopic study. Ultrastruct Pathol 14:291–302
Eidelberg D, Sotrel A, Vogel H, Walker P, Kleefild J, Crumpacker CS III (1986) Progressive polyradiculopathy in acquired immune deficiency syndrome. Neurology 36:912–916
Facchetti F, de Wolf-Peeters C, Mason D, Pulford K, Van den Oord JJ, Desmet VJ (1988) Plasmacytoid T cells: immunohistochemical evidence for their monocyte-macrophage origin. Am J Pathol 133-15-21
Fuller GN, Jacobs JM (1989) Cytomembranous inclusions in the peripheral nerves in AIDS. Acta Neuropathol 79:336–339
Gherardi R, Lebargy F, Gaulard P, Mhiri C, Bernaudin JF, Gray F (1989) Necrotizing vasculitis and HIV replication in peripheral nerves. N Engl J Med 321:685–686
Ho DD, Rota TR, Schooley RT, Kaplan JC, Allan JD, Groopman IE, Resnick L, Felsenstein D, Andrews CA, Hirsch MS (1995) Isolation of HTLV-III from cerebrospinal fluid and neural tissues of patients with neurologic syndromes related to the acquired immunodeficiency syndrome. N Engl J Med 313:1493–1497
Hogenhuis JA, Hénin D, Ratinahirana H, Chaunu MP, Léger JM, Hauw JJ (1991) Caractérisation des infiltrats cellulaires inflammatoires des neuropathies périphériques de l'infection par le virus de l'immunodéficience humaine. Presse Med 20–1107
Lipkin WI, Parry G, Kiprov D, Abrams D (1985) Inflammatory neuropathy in homosexual men with lymphadenopathy. Neurology 35:1479–1483
Mahieux F, Gray F, Fenelon G, Gherardi R, Adams D, Guillard A, Poirier J (1989) Acute myeloradiculitis due to cytomegalovirus as the initial manifestation of AIDS. J Neurol Neurosurg Psychiatry 52:270–274
Parry GJ (1988) Peripheral neuropathies associated with human immunodeficiency virus infection. Ann Neurol 23 [Suppl]:S49-S53
Piette AM, Tusseau F, Vignon D, Chapman A, Parrot G, Leibowitch J, Montagnier L (1986) Acute neuropathy coincident with seroconversion for anti LAV/HTLV III. Lancet I:852
Prineas JW (1972) Acute idiopathic polyneuritis. An electron microscope study. Lab Invest 26:133–147
Prineas JW, McLeod JG (1976) Chronic relapsing polyneuritis. J Neurol Sci 27:427–458
Said G, Lacroix-Ciaudo C, Fujimura H, Blas C, Faux N (1988) The peripheral neuropathy of necrotizing arteritis: a clinicopathological study. Ann Neurol 23:461–465
Said G, Lacroix C, Chemouilli P, Goulon-Goeau C, Roullet E, Penaud D, de Broucker T, Meduri G, Vincent D, Torchet M, Vittcoq D, Leport C, Vildé JL (1991) Cytomegalovirus neuropathy in acquired immunodeficiency syndrome: a clinical and pathological study. Ann Neurol 29:139–146
Snider WD, Simpson DM, Nielsen S, Gold JWM, Metroka CE, Posner JB (1983) Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol 14:403–418
Vinters HV, Guerra WF, Eppolito L, Keith III PE (1988) Necrotizing vasculitis of the nervous system in a patient with AIDS-related complex. Neuropathol Appl Neurobiol 14:417–424
Vinters HV, Anders KH (1990) Neuropathology of AIDS. CRC Press, Boca Raton
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Vital, A., Beylot, M., Vital, C. et al. Morphological findings on peripheral nerve biopsies in 15 patients with human immunodeficiency virus infection. Acta Neuropathol 83, 618–623 (1992). https://doi.org/10.1007/BF00299411
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DOI: https://doi.org/10.1007/BF00299411