Advertisement

Lymphadenopathy: End-Point Prodrome? Update of a 36-Month Prospective Study

  • Donald I. Abrams
  • Timothy Mess
  • Paul A. Volberding
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 187)

Abstract

In contrast to the situation in London described by Pinching, San Francisco physicians were faced with the challenge of persistent lymphadenopathy in homosexual men even before the AIDS epidemic had been defined(l). Although the initial cases of the lymphadenopathy syndrome were first appreciated in 1979, the prospective natural history study in our clinic was only initiated in November 1981(2). The 200 patients enrolled in this study clearly do not constitute the entirety of lymphadenopathy patients in San Francisco. Since the lymphadenopathy syndrome is not reportable to the Centers for Disease Control or the City Health Department, estimates of the number of men affected in the San Francisco area are difficult to obtain. As part of a case control study of 150 of our first AIDS patients, Moss and the Epidemiology group at San Francisco General Hospital interviewed and examined 300 matched controls(3). One hundred fifty participants were neighborhood controls, matched by age, race and socio-economic status to patients residing in the vicinity. One hundred fifty further controls were obtained from the municipal venereal disease clinic, also matched as closely as possible to cases.

Keywords

Opportunistic Infection Herpes Zoster Acquire Immune Deficiency Syndrome Acquire Immunodeficiency Syndrome Immune Deficiency Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    A. J. Pinching, Longitudinal immunological studies on a cohort of homosexual men in London with respect to HTLV III/LAV serology. This volume.Google Scholar
  2. 2.
    D. I. Abrams, B. J. Beckstead, J. H. Casavant C., and W. L. Drew. Persistent diffuse lymphadenopathy in homosexual men: Endpoint or prodrome? Ann Int Med, 100: 801 (1984).PubMedGoogle Scholar
  3. 3.
    D. Osmond, A. R. Moss, P. Bachetti, P. Volberding, F. Barre-Sinoussi, J. and C. Chermann. A case-control study of risk factors for AIDS in San Francisco, International Conference on Acquired Immunodeficiency Syndrome ( AIDS ), Atlanta, GA (1985).Google Scholar
  4. 4.
    A. R. Moss, D. Osmond, P. Bachetti, D. Abrams, F. Barre- Sinnoussi and J. C. Chermann. One year followup of men exposed to AIDS in San Francisco, International Conference on Acquired Immunodeficiency Syndrome ( AIDS ), Atlanta, GA (1985).Google Scholar
  5. 5.
    L. Bye. Research and Decisions Corporation telephone survey for the San Francisco AIDS Foundation, International Conference on Acquired Immunodeficiency Syndrome ( AIDS ), Atlanta, GA (1985).Google Scholar
  6. 6.
    W. E. Finkbeiner, B. M. Egbert, J. R. Groundwater and R. W. Sagebiel. Kaposi’s sarcoma in young homosexual men, Arch Pathol Lab Med 106: 261 (1982).PubMedGoogle Scholar
  7. 7.
    J. L. Ziegler, J. A. Beckstead, P. A. Volberding, D. I. Abrams, A. M. Levine, R. J. Lukes et al. Non-Hodgkin1s lymphoma in 90 homosexual men: Relationship to generalized lymphadenopathy and acquired immunodeficiency syndrome (AIDS, New Engl J Med 311: 565 (1984).PubMedCrossRefGoogle Scholar
  8. 8.
    S. L. Schoeppel, R. T. Hoppe, R. F. Dorfman et al. AIDS and Hodgkin’s disease, in: “Frontiers of Radiation Therapy and Oncology - Cancer and AIDS”, Vol. 19, J. M. Vaeth, ed., Karger Publishing Co., Basal, pp 66–73, (1985).Google Scholar
  9. 9.
    M. L. Freeman and G. H. Talbot. Nongranulomatous mycobacterial lymphadenitis in homosexual patients. Laboratory Investigation 48: 27A (abstract) (1983).Google Scholar
  10. 10.
    D. I. Abrams, M. Robia, W. Blumenfeld, J. Simonson., M. B. Cohen, and W. K. Hadley. Disseminated coccidioidogmycosis in AIDS, New Engl J Med 310: 986 (1984).PubMedCrossRefGoogle Scholar
  11. 11.
    H. L. Joachim. Toxoplasma lymphadenitis, in: “Lymph Node Biopsy”, J. B. Lippincott Co., Philadelphia, Pa (1985).Google Scholar
  12. 12.
    B. J. Luft, R. G. Brooks, F. K. Conley, R. E. McCabe and J. S. Remington. Toxoplasmic encephalitis in patients with acquired immune deficiency syndrome, JAMA 252: 913 (1984).PubMedCrossRefGoogle Scholar
  13. 13.
    W. Blumenfeld and J. H. Beckstead. Angioimmunoblastic lymphadenopathy with dysproteinemia in homosexual men with acquired immune deficiency syndrome, Arch Pathol Lab Med 107: 567 (1983).PubMedGoogle Scholar
  14. 14.
    N. A. Lachant, L. A. Leung, N. C. J. Sun and R. S. Oseas. Angiofollicular lymph node hyperplasia (Castleman’s disease) and Kaposi’s sarcoma in 2 homosexual males with AIDS, Blood 62 (Suppl. 1 ): 113a (abstract) (1983).Google Scholar
  15. 15.
    R. K. Brynes, W. C. Chan, T. J. Spira et al. Value of lymph node biopsy in unexplained lymphadenopathy in homosexual men, JAMA 250: 1313 (1983).PubMedCrossRefGoogle Scholar
  16. 16.
    H. L. Ioachim, C. W. Lerner and M. L. Tapper. Lymphadenopathies in homosexual men: Relationships with the acquired immune deficiency syndrome, JAMA 250: 1306 (1983).PubMedCrossRefGoogle Scholar
  17. 17.
    C. E. Metroka, S. Cunningham-Rundles, M. S. Pollack et al. Generalized lymphadenopathy in homosexual men, Ann Int Med 99: 585 (1983).PubMedGoogle Scholar
  18. 18.
    C. E. Metroka. Generalized lymphadenopathy in homo-sexual men, in: “AIDS: The Epidemic of Kaposi’s Sarcoma and Opportunistic Infections”, A. E. Friedman-Kien ( with L. J. Laubenstein ), ed., Masson, New York (1984).Google Scholar
  19. 19.
    C. Metroka, S. Cunningham-Rundles, J. Mouradian and A. Moore. Generalized lymphadenopathy in intravenous drug users, Blood 62 (Suppl. 1 ): 114a (abstract) (1983).Google Scholar
  20. 20.
    A. E. Pitchenik, M. A. Fischl, G. M. Dickinson et al. Opportunistic infections and Kaposi’s sarcoma among Haitians: Evidence of a new acquired immunodeficiency state, Ann Irrt Med 99: 277 (1983).Google Scholar
  21. 21.
    J. E. Menitove, R. H. Aster, J. T. Casper et al. T- lymphocyte subpopulations in patients with classic hemophila treated with cryoprecipitate and lyophilized concentrates, New Engl J Med 308: 83 (1983).PubMedCrossRefGoogle Scholar
  22. 22.
    W. A. Andes, R. D. de Shazo, R. J. Reed, J. C. Harkin and N. Wong. Hemophilic lymphadenopathy: Clinical histologic, cytologic and chromosomal changes in patients with immune deficiency, Blood 62 (Suppl. 1 ): 1082 (abstract) (1983).Google Scholar
  23. 23.
    T. Han, H. Ozer, E. Daday, Clinical and laboratory findings in prison-acquired lymphoprolif- erative syndrome (PALS) with special reference to AIDS, Blood 62 (Suppl. l):llla (abstract) (1983).Google Scholar
  24. 24.
    Centers for Disease Control. Immunodeficiency among female sexual partners of males with acquired immune deficiency syndrome (AIDS-New York, Morbid Mortal Weekly Report 31: 697 (1983).Google Scholar
  25. 25.
    C. Harris, C. B. Small, R. S. Klein et al. Immunodeficiency in female sexual partners of men with the acquired immunodeficiency syndrome, New Engl J Med 308: 1181 (1983).PubMedCrossRefGoogle Scholar
  26. 26.
    A. J. Pinching, T. J. McManus, D. J. Jeffries, Studies of cellular immunity in male homosexuals in London, Lancet ii: 126 (1983).Google Scholar
  27. 27.
    J. E. Kaplan, D. B. Fishbein, T. J. Spirz, B. Miller, L. B. Schönberger and P. E. Pinsky. Unexplained generalized lymphadenopathy in homosexual men - the Atlanta experience. This volume.Google Scholar
  28. 28.
    D. I. Abrams. Asymptomatic lymphadenopathy and other early presentations of AIDS, in: “Frontiers of Radiation Therapy and Oncology - Cancer and AIDS”, Vol. 19, J. M. Vaeth, ed., Karger Publishing Co., Basal, pp 59–65 (1985).Google Scholar
  29. 29.
    D. Abrams, D. Kiprov, R. Strieker and P. Volberding. Prednisone therapy in AIDS-related immune thrombo-cytopenia (ITP): Clinical, hematologic and immunologic consequences, Proceedings American Society of Clinical Oncology, Vol. 4 (1985).Google Scholar
  30. 30.
    M. S. Gottlieb, P. R. Wolfe, D. Hardy, A. Jacobs, L. Eppolito, M. G. Sarngadharan, R. C. Gallo and J. L. Fahey. Persistent generalized lymphadenopathy: The UCLA experience. This volume.Google Scholar
  31. 31.
    J. S. Greenspan, D. Greenspan, E. Lennette, M. Conant, D. Abrams, V. Petersen and Y. de Souza. Oral “hairy” leukoplakia - evidence of both papillomavirus & Epstein- Barr virus. This volume.Google Scholar
  32. 32.
    K. L. Moon, M. P. Federle, D. I. Abrams, P. A. Volberding and B. J. Lewis. Kaposi’s sarcoma and lymphadenopathy syndrome: Limitations of the abdominal CT in acquired immunodeficiency syndrome, Radiology 150: 479 (1984).PubMedGoogle Scholar
  33. 33.
    R. G. Stern, G. Gamsu, J. A. Golden, M. Marji, W. R. Webb and D. I. Abrams. Intrathoracic adenopathy in AIDS and the diffuse, persistent lymphadenopathy syndrome: Diagnostic and clinical implications, Am J Roentgenol 142: 689 (1984).Google Scholar
  34. 34.
    U. Mathur-Wagh. Persistent generalized lymphadenopathy in homosexual men. This volume.Google Scholar
  35. 35.
    H. C. Lane, H. Masur, L. C. Egar, et al. Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome, New Engl J Med 309: 453 (1983).PubMedCrossRefGoogle Scholar
  36. 36.
    A. J. Ammann, G. Schiffman, D. I. Abrams, et al. B-cell immunodeficiency in acquired immune deficiency syndrome, JAMA 251: 1447 (1984).PubMedCrossRefGoogle Scholar
  37. 37.
    A. Ammann, D. Abrams, M. Conant, D. Chudwin, M. Cowan, P. A. Volberding, B. Lewis and C. Casavant. Acquired immune dysfunction in homosexual men: Immunologic profiles, Clin Immunol Immunopathol 27: 315 (1983).PubMedCrossRefGoogle Scholar
  38. 38.
    J. A. Golden, D. I. Abrams, R. J. Hattner, Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome: A diagnostic approach. Submitted.Google Scholar
  39. 39.
    E. De Stefano, R. M. Friedman, A. E. Friedman-Kien, et al. Acid-labile human leukocyte interferon in homo-sexual men with Kaposi’s sarcoma and lymphadenopathy, J Inf Pis 146: 451 (1982).CrossRefGoogle Scholar
  40. 40.
    K. Welte, N. Ciobanu, G. Kruger et al. Impaired interleukin–2 production in response to PHA and 0KT3 antibody in male homosexuals with acquired imune deficiency syndrome: In vitro restoration of T-cell proliferation by highly purified Interleukin–2, in: AIDS: The Epidemic of Kaposi’s Sarcoma and Opportunistic Infections, A. E. Friedman-Kien (with L. J. Laubenstein), ed., Masson, New York pp 199–205 (1984).Google Scholar
  41. 41.
    A. R. Moss, G. McCallum, P. A. Volberding, P. Bacchetti, S. Dritz. Mortality associated with mode of presentation in the acquired Immune deficiency syndrome, JNCI 73, No. 6: 1281 (1984).PubMedGoogle Scholar
  42. 42.
    R. L. Modlin, P. R. Meyer, F. M. Hofman et al. T- lymphocyte subsets in lymph nodes from homosexual men, JAMA 240: 1302 (1983).CrossRefGoogle Scholar
  43. 43.
    R. W. Enlow, A. Nunez-Roldan, P. Lo Gallo, Increased frequency of HLA-DR5 in lymphadenopathy stage of AIDS. Lancet ii: 51 (1983).Google Scholar
  44. 44.
    R. Enlow, D. Mildvan, U. Mathur et al. Acquired immune deficiency syndrome (AIDS): Definition of a prodrome associated with HLA-DR5, Clinical Research 31: 342a (1983).Google Scholar
  45. 45.
    M. E. Eyster, J. J. Goedert, P. Man-Chiu, 0. T. Preble. Acid-labile alpha interferon. A possible preclinical marker for the acquired immunodeficiency syndrome in hemophilia, New Engl J Med 309: 583 (1983).PubMedCrossRefGoogle Scholar
  46. 46.
    D. I Abrams and P. A. Volberding. Lymphadenopathy in homosexual men: Factors predictive of transformation to AIDS, Proc Am Soc Clin One 3: 53 (1984).Google Scholar
  47. 47.
    F. Barro-Sinoussi, J. C. Chermann, F. Rey et al. Isolation of a T-lymphotropic retrovirus from a partient at risk for acquired immune deficiency syndrome (AIDS). Science 220: 668 (1983).Google Scholar
  48. 48.
    E. P. Gelmann, M. Popovic, D. Blayney et al. Proviral DNA of a retrovirus, human T-cell leukemia virus, in two patients with AIDS. Science 220: 862 (1983).PubMedCrossRefGoogle Scholar
  49. 49.
    R. C. Gallo, P. S. Sarin, E. P. Gelmann et al. Isolation of human T-cell leukemia virus in acquired immunodeficiency syndrome (AIDS), Science 220: 865 (1983).PubMedCrossRefGoogle Scholar
  50. 50.
    B. Poiesz, R. Tornar, S. Merl et al. Detection of human T-cell lymphoma/leukemia virus (HTLV) in patients with acquired immunodeficiency (AIDS) or generalized lymphadenopathy syndrome (GLS), Blood 62 (Suppl. 1 ): 115a (abstract) (1983).Google Scholar

Copyright information

© Plenum Press, New York 1985

Authors and Affiliations

  • Donald I. Abrams
    • 1
  • Timothy Mess
    • 1
  • Paul A. Volberding
    • 1
  1. 1.San Francisco General HospitalUSA

Personalised recommendations