Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
LYMPHADENOPATHY SYNDROME IN MALE HOMOSEXUALS
Adv Host Def Mech; 5:75-97 1985. Unique Identifier : AIDSLINE ICDB/85612998 Abrams DI; Department of Medicine, University of California, San Francisco,; CA 94110
Abstract:
Lymphadenopathy syndrome in male homosexuals is discussed under the following headings: incidence, lymph node histopathology, clinical syndrome, laboratory evaluation, immunologic evaluation, virologic evaluation, and natural history. The differential diagnosis of diffuse lymphadenopathy in a homosexual man today includes many disorders that were almost unheard of in the population 10 yr ago. Lymphadenopathy as a physical finding may be associated with both the neoplastic and infectious complications of acquired immunodeficiency syndrome (AIDS). The actual incidence of the lymphadenopathy syndrome among homosexual men in any AIDS endemic area is unknown. Nonspecific reactive lymphoid hyperplasia is a common finding on lymph node biopsy performed in adults without known underlying malignancy; this diagnosis accounts for up to 50% of pathology reports in evaluation of generalized lymphadenopathy. Lymphadenopathy patients have past histories of sexual activity, sexually transmitted disease, and use of recreational drugs similar to those reported in homosexual men with AIDS. Syphilis and non-B hepatitis, however, are reported less frequently in lymphadenopathy patients than in patients with bona fide AIDS. The lymphadenopathy syndrome represents a disorder of immune regulation. On the one hand, the B-lymphocyte function of these patients appears to be hyperactive; on the other hand, the cellular immune function is impaired in a manner similar to, but of lesser degree than that which has been described in patients with AIDS. Serologic evaluation has demonstrated antibodies to cytomegalovirus and the Epstein-Barr virus in all the men with persistent lymphadenopathy in the San Francisco study and others. The true natural history of the syndrome will require continued longitudinal evaluation, considering the lengthy incubation period of the AIDS virus. Currently, it appears that men with the lymphadenopathy syndrome are manifesting an alternative phenotypic response to the same insult that caused AIDS in other susceptible members of the subpopulation. (90 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Adult Antibody Formation California *Homosexuality Human Immunity, Cellular Lymph Nodes/PATHOLOGY Lymphatic Diseases/COMPLICATIONS/DIAGNOSIS/IMMUNOLOGY/*PATHOLOGY JOURNAL ARTICLE REVIEW
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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.
