Which histologic findings are characteristic of postpolio syndrome (PPS)?

Updated: Apr 28, 2014
  • Author: Hidehiro Takei, MD; Chief Editor: Adekunle M Adesina, MD, PhD  more...
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Answer

Answer

In postpolio syndrome (PPS), the spinal cord demonstrates active chronic inflammation with perivascular lymphoplasmacytic infiltrate in the anterior horns and leptomeninges. [47] The cord gray matter is gliotic, with axonal spheroids seen in the anterior horns. No degenerative changes are noted in the lateral columns, in contrast to the findings in ALS. These features are not specific to PPS: similar changes are seen in patients with stable postpoliomyelitis deficits. [47]

Miller noted focal, perivascular, intraparenchymal, chronic inflammatory infiltrates composed mostly of B cells with rare macrophages and no T cells in the spinal cord, suggesting an autoimmune etiology; he also noted neuronal loss with profound gliosis and scattered axonal spheroids in the anterior horns, moderate Wallerian degeneration in the lateral columns, and an unremarkable brain, specifically the internal capsule and precentral gyri. [33] Muscle biopsy showed neurogenic changes with secondary myopathic features of varying degree.


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