Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome

Carol Petito, B. A. Navia, E. S. Cho, B. D. Jordan, D. C. George, R. W. Price

Research output: Contribution to journalArticle

406 Citations (Scopus)

Abstract

Twenty of 89 consecutive patients with the acquired immunodeficiency syndrome (AIDS) in whom autopsies were performed over a 3 1/2 -year period had a vacuolar myelopathy that was most severe in the lateral and posterior columns of the thoracic cord. Light and electron microscopy showed that vacuoles were surrounded by a thin myelin sheath and appeared to arise from swelling within myelin sheaths. Signs and symptoms referable to the spinal-cord lesions, including paraparesis, often accompanied by spasticity or ataxia (or both), were present in all five patients with marked pathological changes in five of seven patients with moderate changes, and in two of eight patients with mild changes. Fourteen patients were demented. The clinical presentation was sufficiently distinctive to provide a guide for antemortem diagnosis. Possible causes of the vacuolar changes include uncharacterized viral infection or a metabolic derangement related to selective nutritional deficiency.

Original languageEnglish
Pages (from-to)874-879
Number of pages6
JournalNew England Journal of Medicine
Volume312
Issue number14
StatePublished - Jun 19 1985
Externally publishedYes

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Subacute Combined Degeneration
Spinal Cord Diseases
Acquired Immunodeficiency Syndrome
Myelin Sheath
Spinal Cord
Paraparesis
Virus Diseases
Ataxia
Vacuoles
Malnutrition
Signs and Symptoms
Autopsy
Electron Microscopy
Light

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Petito, C., Navia, B. A., Cho, E. S., Jordan, B. D., George, D. C., & Price, R. W. (1985). Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. New England Journal of Medicine, 312(14), 874-879.

Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. / Petito, Carol; Navia, B. A.; Cho, E. S.; Jordan, B. D.; George, D. C.; Price, R. W.

In: New England Journal of Medicine, Vol. 312, No. 14, 19.06.1985, p. 874-879.

Research output: Contribution to journalArticle

Petito, Carol ; Navia, B. A. ; Cho, E. S. ; Jordan, B. D. ; George, D. C. ; Price, R. W. / Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immunodeficiency syndrome. In: New England Journal of Medicine. 1985 ; Vol. 312, No. 14. pp. 874-879.
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