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Inflammatory neuroprithy in homosexual men with lymphadenopathy

From the Departments of Neurology and Medicine, University of California School of Medicine, and the Departments of Mrdicine and Clinical Immunology, Childrens Hospital, San Francisco, CA.

Twelve homosexual men had peripheral neuropathy with fever, night sweats, and lymphadenopathy. Sensory symptoms predominated, but there was also weakness and cranial nerve dysfunction. Manifestations were multifocal in nine and distal and symmetric in three. CSF was abnormal in all eight patients examined. Sural nerve in five patients showed axonal degeneration, accompanied in two by segmental demyelination. Four patients had epineurial and endoneurial perivascular chronic inflammatory cells without evidence of vasculitis. Neuropathy remitted spontaneously in six patients. Four patients received steroids without clinical response, although one later responded to plasmapheresis-lymphocytapheresis. Four patients later progressed to AIDS.

Address correspondence and reprint requests to Dr. Lipkin. Department of Immunology. Scripps Clinic and Research Foundation. 1MM-6. 10666 North Torrey Pines Road, La Jolla, CA 92037.

Dr. Lipkin is a recipient of a postdortriral fellowship Irom the National Multiple Sclerosis Society.

Supported in part hy grant 1 U01 CA 34980 from the National Institutes of Health.

Presented in part at the thirty-sixth annual meeting of the American Academy of Neurology. Boston, MA, April 1984.

Accepted for publication January 28, 1985.

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