[Peripheral neuropathy in relation to LAV/HTLV III retrovirus infection. A clinical, anatomical and immunological study. 5 cases].
An unexplained peripheral neuropathy was observed in five patients with positive serology for LAV/HTLV III. Three of them presented with polyneuropathy, one with chronic meningitis and oculomotor palsies, and one with a mononeuropathy. CSF was abnormal in 5/5, with elevated protein content (0.4-4 g/l) and abnormal cell count (29-65/mm3). Intrathecal production of LAV-specific IgG was demonstrated in 3/4 cases. Electromyographic examination showed reduced nerve conduction velocity in 4/5. Neuromuscular biopsy revealed microvasculitis with mononuclear cell infiltrates in 3/4 cases; characterization of these cells showed that they were predominantly non monoclonal T8 lymphocytes. Other symptoms of "AIDS-related complex" were present in all five patients. None had other causes of peripheral neuropathy. Thus, peripheral neuropathy can be the initial manifestation of LAV/HTLV III infection. Isolation of the virus from the nerve in one published case, and arguments for intrathecal synthesis of LAV-specific IgG suggest the direct role of this agent; however, the lymphocytic infiltration seen in three of our cases favours an indirect immune mechanism, as in other organs, such as lungs and lymph nodes.
D000386:AIDS-Related Complex / Q000150:complications; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009138:Musculocutaneous Nerve / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011129:Polyradiculoneuropathy / Q000175:diagnosis
Neuropathie périphérique en relation avec l'infection par le rétrovirus LAV/HTLV III. Etude clinique, anatomique et immunologique. Cinq observations.