Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients

Stephen S. Kamin, Carol Petito

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Postmortem examination of 21 patients showed a vacuolar myelopathy resembling that associated with the acquired immunodeficiency syndrome. Underlying diseases included six cases of leukemia or lymphoma, five of carcinoma, three of systemic lupus erythematosus, two of chronic lung disease, and one each of cadaveric renal transplant, cirrhosis, diabetes, hemophagocytic syndrome, and viral encephalitis. Fourteen patients were on long-term steroid therapy and 10 of these also had immunosuppressive chemotherapy. No patient had the acquired immunodeficiency syndrome, although one received blood transfusions in 1978. Signs and symptoms consistent with myelopathy included paraparesis in seven patients, ataxia in one, and bilateral extensor plantar reflexes in one. Microscopic examination showed vacuolation in spinal cord white matter primarily located in posterior and lateral columns. Lipid-laden macrophages and axonal changes were proportional to the severity of the vacuolation, which was severe in five patients, moderate in 10, and mild in six. Eight patients had coexistent viral diseases elsewhere in the central nervous system, but viral-associated antigens or genomic material was not found in regions of vacuolated spinal cord white matter. Although the etiology of these myelopathies is unknown, their association with immune suppression and coexistent viral infection of the central nervous system suggests that an opportunistic viral infection may be important.

Original languageEnglish
Pages (from-to)816-824
Number of pages9
JournalHuman Pathology
Volume22
Issue number8
DOIs
StatePublished - Jan 1 1991
Externally publishedYes

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Spinal Cord Diseases
Virus Diseases
Spinal Cord
Acquired Immunodeficiency Syndrome
Central Nervous System Viral Diseases
Babinski's Reflex
Viral Encephalitis
Paraparesis
Hemophagocytic Lymphohistiocytosis
Viral Antigens
Opportunistic Infections
Ataxia
Immunosuppressive Agents
Blood Transfusion
Systemic Lupus Erythematosus
Lung Diseases
Signs and Symptoms
White Matter
Autopsy
Lymphoma

Keywords

  • acquired immunodeficiency syndrome
  • immune suppression
  • myelopathy
  • transverse myelitis
  • vacuolar myelopathy
  • viral myelitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients. / Kamin, Stephen S.; Petito, Carol.

In: Human Pathology, Vol. 22, No. 8, 01.01.1991, p. 816-824.

Research output: Contribution to journalArticle

Kamin, Stephen S. ; Petito, Carol. / Idiopathic myelopathies with white matter vacuolation in non-acquired immunodeficiency syndrome patients. In: Human Pathology. 1991 ; Vol. 22, No. 8. pp. 816-824.
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