Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
LYMPHADENOPATHY-THE SAN FRANCISCO EXPERIENCE
AIDS. The Epidemic of Kaposi's Sarcoma and Opportunistic Infections. Friedman-Kien AE, Laubenstein LJ, eds. New York, Masson, p. 81-8, 1984.. Unique Identifier : AIDSLINE ICDB/85610694 Abrams DI; Cancer Res. Inst., Univ. of California at San Francisco, San; Francisco, CA 94110
Abstract:
In a study of the relation of lymphadenopathy to the Acquired Immune Deficiency Syndrome (AIDS), 70 homosexual or bisexual men from San Francisco were evaluated by history, physical examination, and laboratory studies. All patients (pts) had lymphadenopathy for at least 6 mo. Sixty pts were white, 6 were Hispanic, and 4 were black; mean age was 32.6. Mean age of first sexual contact with a male was 15.5 yr, and mean age of regular homosexual contact was 20.7 yr. Mean number of sexual partners was 788 overall and 91 in the yr preceding lymphadenopathy. Common symptoms included flu-like illnesses, fatigue, fever, nightsweats, wt loss, skin infection, gastrointestinal complaints, headache, and psychological disturbances. Physical examination was generally normal except for the lymphoreticular system. Thirty-seven percent of the lymphadenopathy group demonstrated lymphoid hyperplasia in the posterior pharynx; counting right- and left-sided nodal groups separately, the av number of involved sites was 10. Biopsy of 35 nodes demonstrated benign reactive hyperplasia in 34 and atypical lymphoid hyperplasia in 1, with negative cultures. Routine laboratory evaluation of the pts was remarkable mainly for the lack of abnormalities, except for elevated RBC sedimentation rates in 20%, mildly elevated hepatic transaminases in 10%, generalized increase in gammaglobulin in 71%, elevated IgG in 64%, elevated total hemolytic complement, and low titer antinuclear antibodies in 30%. The mean T-cell helper:suppressor ratio was 0.7. Decreased OKT4 and increased OKT8 were found in two thirds of the pts. Serology was positive for past infection with syphilis in three pts, for hepatitis B in 74%, for Epstein-Barr virus in 100%, and for cytomegalovirus in 100%. Stool protozoa were identified in 60% of the pts. After follow-up of up to 16 mo, no pts developed AIDS. The author concludes that this pattern of lymphadenopathy is demographically similar to AIDS but may be either a precursor to AIDS or an end-stage in itself. Biopsy is recommended for initial evaluation and subsequent clinical changes. Potential therapies include interferons, gammaglobulin, interleukin 2, or plasma exchange. (25 Refs)
Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY Adult Biopsy California Follow-Up Studies *Homosexuality Human Intestinal Diseases, Parasitic/COMPLICATIONS Lymph Nodes/PATHOLOGY Lymphatic Diseases/*DIAGNOSIS/EPIDEMIOLOGY/PATHOLOGY Male Serodiagnosis Skin Diseases, Infectious/COMPLICATIONS MONOGRAPH
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Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
