Premium
Cytomegalovirus neuropathy in acquired immunodeficiency syndrome: A clinical and pathological study
Author(s) -
Said G.,
Lacroix C.,
Chemouilli P.,
GoulonGoeau C.,
Roullet E.,
Penaud D.,
De Broucker T.,
Meduri G.,
Vincent D.,
Torchet M.,
Vittcoq D.,
Leport C.,
Vildé J. L.
Publication year - 1991
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410290205
Subject(s) - medicine , nerve biopsy , pathology , cytomegalovirus , biopsy , peripheral neuropathy , nerve root , brain biopsy , multifocal motor neuropathy , viral disease , immunology , virus , herpesviridae , surgery , mismatch negativity , electroencephalography , endocrinology , psychiatry , diabetes mellitus
We have observed typical cytomegalovirus cytopathology associated with multifocal inflammatory and necrotic lesions of peripheral nerve in biopsy specimens from 4 patients who developed a rapidly progressive, multifocal neuropathy late in the course of human immunodeficiency virus infection. The inflammatory infiltrates, which contained numerous polymorphonuclear cells, were associated with mixed, axonal, and demyelinative lesions of nerve fibers. One of these patients improved on treatment with DHPG (9‐[2‐hydroxy‐1(hydroxymethyl) ethoxymethyl] guanine) and remains stable after 18 months. The other 3 died soon after the onset of the neuropathy. In another patient with acquired immunodeficiency syndrome, who developed a severe, predominantly motor neuropathy of the lower limbs, the nerve biopsy did not reveal cytomegalovirus inclusions, but the neurological deficit improved on treatment with DHPG. The patient died from cachexia 2 months later; numerous cytomegalovirus lesions were found in the spinal cord at the time of postmortem examination. The multifocal necrotic endoneurial nerve lesions with polymorphonuclear cell infiltration we describe may help identify cytomegalovirus neuropathy when characteristic inclusions are not present in the biopsy specimen.