Human immunodeficiency virus (HIV)-related chronic relapsing inflammatory demyelinating polyneuropathy with multifocal unusual onion bulbs in sural nerve biopsy. A clinicomorphological study with qualitative and quantitative light and electron microscopy.
This is obviously the first report on a case with a spontaneous sensu strictu relapsing variant of human immunodeficiency virus (HIV)-related polyneuropathy. Its manifestation preceded LAS. Intrathecal HIV-antibodies developed between the most severe third and fourth episode. Analysis of sural nerve biopsy was consistent with a multifocally accentuated chronic inflammatory demyelination, characterized by unusual onion bulb-like Schwann cell formations with irregular voluminous layers, electron density, aggregation of filaments, multiple indented nuclei, and numerous enclosed collagen pockets. A direct or immune-mediated indirect specific influence on Schwann cell morphology by HIV might be discussed. Virus-like particles and ultrastructural markers of HIV were not detectable.
Gibbels
E
E
Universitäts-Nervenklinik, Köln, Federal Republic of Germany.
Diederich
N
N
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D002908:Chronic Disease; D003711:Demyelinating Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012583:Schwann Cells / Q000648:ultrastructure*; D013127:Spinal Nerves / Q000648:ultrastructure*; D013497:Sural Nerve / Q000648:ultrastructure*