Which histologic findings are characteristic of HIV-associated distal painful sensorimotor polyneuropathy?

Updated: Aug 08, 2019
  • Author: Florian P Thomas, MD, PhD, MA, MS; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Histologic findings include the following:

  • Axonal degeneration

  • Variable demyelination

  • Prominent perivascular infiltration by T-lymphocytes and macrophages

  • Mild loss of dorsal root ganglion neurons, some found to harbor HIV by in situ polymerase chain reaction (PCR)

  • Occasional gracile tract degeneration

  • Reduced mtDNA in subcutaneous fat

  • Reduced HIV-RNA viral load

The intraepidermal nerve fiber density correlates inversely with the likelihood of neuropathic symptoms.


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