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Spinal Cord and Peripheral Nerve Pathology in AIDS:The Roles of CMV & HIV
Ann Neurol 25:561-566, Grafe,M.R.&Wiley,C.A., 1989
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Article Abstract
We examined spinal cords,nerve roots,or peripheral nerves of 27 patients who died with acquired immunodeficiency syndrome(AIDS)for the presence of cytomegalovirus(CMV)and human immunodeficiency virus(HIV)by immunoperoxidase techniques in paraffin-embedded tissue.Vacuolar myelopathy was seen in 8 of 26 spinal cords(31%)and microglial nodules were seen in 13(50%).All of the patients with lateral column vacuolar myelopathy showed severe brain pathology.HIV antigens had been detected in the brains of 15(55%)of the 27 patients but were detected in only 3(11%)of 26 spinal cords and were not localized to regions of vacuolar myelopathy. This suggests that the vacuolar myelopathy may be due to a remote or indirect effect of HIV or other infectious agent.CMV antigens were detected in none of the patients who showed vacuolar myelopathy but were detected in 2 of the 13 with microglial nodules.Focal nerve root or peripheral nerve inflammation was seen in 7 patients;4 had CMV antigens and none had HIV antigens.CMV appears to be an important cause of inflammatory peripheral neuropathy in AIDS patients.
 
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acquired immunodeficiency syndrome
cytomegalovirus infection
human immunodeficiency virus type 1
immunoperoxidase staining
microglial nodules
multinucleated giant cell
myelopathy,vacuolar
neuropathology
neuropathology,brain
neuropathology,peripheral nerves
neuropathy
neuropathy,peripheral
spinal cord,pathologic exam of

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