Syndrome of persistent generalized lymphadenopathies parenteral drug addicts. Clinical, immunological and histopathological study of 18 cases
Aguilar Ligorit, E.; Guix García, J.; Sánchez Fernández de Sevilla, C.; Escrig Orenga, V.; Alberola Candel, V.; Llombart Bosch, A.; García-Conde Bru, J.
Medicina Clinica 91(7): 256-260
1988
ISSN/ISBN: 0025-7753 PMID: 3193832 Document Number: 310151
We report the epidemiological, clinical, immunological and histopathological findings in 18 parenteral drug abusers with the syndrome of persistent generalized lymphadenopathy. A remarkable clinical finding was the longer duration of symptoms than in reported series of homosexual males, as well as the problems in the differential diagnosis of the histological findings in lymph nodes owing to the high incidence of infectious diseases. The observed immunological abnormalities indicate a disorder of both cellular and humoral immunity, as shown by an important reduction in T-helper population and a polyclonal activation of B lymphocytes, generating global hypergammaglobulinemia, as well as by circulating immune complexes. The most common histopathological finding was follicular hyperplasia of germinative centers, found in all patients; although it is not specific for this condition, it helps to rule out other causes of multiple lymphadenopathy. In the follow-up, three patients developed AIDS 13 months after the initial diagnosis. As prognostic factors, predictive of the evolution to AIDS, we have found the overall count of T-helper leukocytes and IgA hypergammaglobulinemia, although wider studies may disclose the true prognostic value of these parameters.