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September 7, 1984, Vol 252, No. 9 >
ARTICLE | September 7, 1984

Autopsy Findings in the Acquired Immune Deficiency Syndrome FREE

Kevin Welch, MD; Walter Finkbeiner, MD; Charles E. Alpers, MD; Walter Blumenfeld, MD; Richard L. Davis, MD; Edward A. Smuckler, MD, PhD; Jay H. Beckstead, MD
[+] Author Affiliations

Reprint requests to Department of Pathology, HSW 501, University of California School of Medicine, San Francisco, CA 94143 (Dr Beckstead).


JAMA. 1984;252(9):1152-1159. doi:10.1001/jama.1984.03350090028018
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References

The medical records, premortem biopsy specimens, and autopsy materials from 36 patients with acquired immune deficiency syndrome (AIDS) were reviewed. The majority of the patients were homosexual men. Widely metastatic Kaposi's sarcoma was seen in eight patients, while tumor was confined to the skin in an additional ten. Four patients had high-grade lymphomas. Thirty-five of the 36 patients had at least one opportunistic infection at some point in the course of their illness. Many patients had multiple infectious agents. The most consistent and striking autopsy finding was a severe depletion of lymphoid tissues. Death in the majority (83%) of the patients was attributable to opportunistic infections affecting most commonly the respiratory tract (64%) and meninges (11%). Three patients (9%) died with widely metastatic Kaposi's sarcoma and secondary hemorrhage.

(JAMA 1984;252:1152-1159)

REFERENCES

1 +
 Pneumocystis pneumonia—Los Angeles . MMWR 1981;;30:250-252.
2 +
 Kaposi's sarcoma and pneumocystis pneumonia among homosexual men—New York City and California . MMWR 1981;;30:305-308.
3 +
Masue H, Michelis MA, Green JB, et al:  An outbreak of community-acquired Pneumocystis carinii pneumonia: Initial manifestations of cellular dysfunction . Ann Intern Med 1981;;305:1431-1438.
4 +
 Opportunistic infections and Kaposi's sarcoma among Haitians in the United States . MMWR 1982;;31:353-361.
5 +
Vieira J, Frank E, Spira TJ, et al:  Acquired immune deficiency in Haitians . N Engl J Med 1983;;308:125-129.
6 +
 Pneumocystis carinii pneumonia among persons with hemophilia A . MMWR 1982;;31:365-367.
7 +
Poon M, Landry A, Prasthofer E, et al:  Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium-intracellulare infection in a previously healthy patient with classic hemophilia . Ann Intern Med 1983;;98:287-290.
8 +
Oleski J, Minnefor A, Cooper R Jr, et al:  Immune deficiency syndrome in children . JAMA 1983;;249:2345-2349.
9 +
Curran JW, Lawrence DN, Jaffe H, et al:  Acquired immunodeficiency syndrome (AIDS) associated with transfusions . N Engl J Med 1984;;310:69-75.
10 +
Reichert CM, O'Leary TJ, Levens DL, et al:  Autopsy pathology in the acquired immunodeficiency syndrome . Am J Pathol 1983;;112:357-382.
11 +
Al'Khafaji K, Rotterdam H, Lerner CW, et al:  Autopsy findings in six patients with acquired immunodeficiency syndrome . Lab Invest 1983;;48:2A.
12 +
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profiles . Clin Immunol Immunopathol 1983;;27:315-325.
13 +
Lawton AR, Cooper MD:  Immune deficiency diseases , in Petersdorf RG, Adams RD, Braunwald E, et al (eds): Principles of Internal Medicine . New York, McGraw-Hill Book Co, 1983;.
14 +
Penn I:  Kaposi's sarcoma in organ transplant recipients . Transplantation 1979;;27:8-11.
15 +
Penn I:  Development of cancer as a complication of clinical transplantation . Transplantation Proc 1977;;9:1121-1127.
16 +
Stahl RE, Friedman-Kien A, Dubin R, et al:  Immunologic abnormalities in homosexual men: Relationship to Kaposi's sarcoma . Am J Med 1982;;73:71-78.
17 +
Gottlieb MS, Schroff R, Schanker HM, et al:  Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: Evidence of a new acquired cellular immunodeficiency . N Engl J Med 1981;;305:1425-1431.
18 +
Siegal FP, Lopez C, Hammer GS, et al:  Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions . N Engl J Med 1981;;305:1439-1444.
19 +
Mavligit GM, Talpaz M, Hsia FT, et al:  Chronic immune stimulation by sperm alloantigens: Support for the hypothesis that spermatozoa induce immune dysregulation in homosexual males . JAMA 1984;;251:237-241.
20 +
Topper ML, Rotterdam HZ, Lerner CW, et al:  Adrenal necrosis in the acquired immunodeficiency syndrome . Ann Intern Med 1984;;100:239-241.
21 +
Rao TKS, Filippone EJ, Nicostri AD, et al:  Associated focal and segmental glomerulosclerosis in the acquired immunodeficiency syndrome . N Engl J Med 1984;;310:669-673.
22 +
Spargo BH, Seymour AE, Ordonez NG: Renal Biopsy Pathology With Diagnostic and Therapeutic Implications . New York, John Wiley & Sons Inc, 1983;.
23 +
Hendrickson RV, Osborn KG, Madden DL, et al:  Epidemic of acquired immunodeficiency in rhesus monkeys . Lancet 1983;;1:388-390.
24 +
Letvin NL, Eaton KA, Aldrich WR, et al:  Acquired immunodeficiency syndrome in a colony of macaque monkeys . Proc Natl Acad Sci USA 1983;:80:2718-2722.
25 +
Osborn KG, Prahalada S, Lowenstine LJ, et al:  The pathology of an epizootic of acquired immunodeficiency in rhesus macaques . Am J Pathol 1984;;114:94-103.
26 +
King NW, Hunt RD, Letvin NL:  Histopathologic changes in macaques with an acquired immunodeficiency syndrome (AIDS) . Am J Pathol 1983;;113:382-388.

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1 +
 Pneumocystis pneumonia—Los Angeles . MMWR 1981;;30:250-252.
2 +
 Kaposi's sarcoma and pneumocystis pneumonia among homosexual men—New York City and California . MMWR 1981;;30:305-308.
3 +
Masue H, Michelis MA, Green JB, et al:  An outbreak of community-acquired Pneumocystis carinii pneumonia: Initial manifestations of cellular dysfunction . Ann Intern Med 1981;;305:1431-1438.
4 +
 Opportunistic infections and Kaposi's sarcoma among Haitians in the United States . MMWR 1982;;31:353-361.
5 +
Vieira J, Frank E, Spira TJ, et al:  Acquired immune deficiency in Haitians . N Engl J Med 1983;;308:125-129.
6 +
 Pneumocystis carinii pneumonia among persons with hemophilia A . MMWR 1982;;31:365-367.
7 +
Poon M, Landry A, Prasthofer E, et al:  Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium-intracellulare infection in a previously healthy patient with classic hemophilia . Ann Intern Med 1983;;98:287-290.
8 +
Oleski J, Minnefor A, Cooper R Jr, et al:  Immune deficiency syndrome in children . JAMA 1983;;249:2345-2349.
9 +
Curran JW, Lawrence DN, Jaffe H, et al:  Acquired immunodeficiency syndrome (AIDS) associated with transfusions . N Engl J Med 1984;;310:69-75.
10 +
Reichert CM, O'Leary TJ, Levens DL, et al:  Autopsy pathology in the acquired immunodeficiency syndrome . Am J Pathol 1983;;112:357-382.
11 +
Al'Khafaji K, Rotterdam H, Lerner CW, et al:  Autopsy findings in six patients with acquired immunodeficiency syndrome . Lab Invest 1983;;48:2A.
12 +
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profiles . Clin Immunol Immunopathol 1983;;27:315-325.
13 +
Lawton AR, Cooper MD:  Immune deficiency diseases , in Petersdorf RG, Adams RD, Braunwald E, et al (eds): Principles of Internal Medicine . New York, McGraw-Hill Book Co, 1983;.
14 +
Penn I:  Kaposi's sarcoma in organ transplant recipients . Transplantation 1979;;27:8-11.
15 +
Penn I:  Development of cancer as a complication of clinical transplantation . Transplantation Proc 1977;;9:1121-1127.
16 +
Stahl RE, Friedman-Kien A, Dubin R, et al:  Immunologic abnormalities in homosexual men: Relationship to Kaposi's sarcoma . Am J Med 1982;;73:71-78.
17 +
Gottlieb MS, Schroff R, Schanker HM, et al:  Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: Evidence of a new acquired cellular immunodeficiency . N Engl J Med 1981;;305:1425-1431.
18 +
Siegal FP, Lopez C, Hammer GS, et al:  Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions . N Engl J Med 1981;;305:1439-1444.
19 +
Mavligit GM, Talpaz M, Hsia FT, et al:  Chronic immune stimulation by sperm alloantigens: Support for the hypothesis that spermatozoa induce immune dysregulation in homosexual males . JAMA 1984;;251:237-241.
20 +
Topper ML, Rotterdam HZ, Lerner CW, et al:  Adrenal necrosis in the acquired immunodeficiency syndrome . Ann Intern Med 1984;;100:239-241.
21 +
Rao TKS, Filippone EJ, Nicostri AD, et al:  Associated focal and segmental glomerulosclerosis in the acquired immunodeficiency syndrome . N Engl J Med 1984;;310:669-673.
22 +
Spargo BH, Seymour AE, Ordonez NG: Renal Biopsy Pathology With Diagnostic and Therapeutic Implications . New York, John Wiley & Sons Inc, 1983;.
23 +
Hendrickson RV, Osborn KG, Madden DL, et al:  Epidemic of acquired immunodeficiency in rhesus monkeys . Lancet 1983;;1:388-390.
24 +
Letvin NL, Eaton KA, Aldrich WR, et al:  Acquired immunodeficiency syndrome in a colony of macaque monkeys . Proc Natl Acad Sci USA 1983;:80:2718-2722.
25 +
Osborn KG, Prahalada S, Lowenstine LJ, et al:  The pathology of an epizootic of acquired immunodeficiency in rhesus macaques . Am J Pathol 1984;;114:94-103.
26 +
King NW, Hunt RD, Letvin NL:  Histopathologic changes in macaques with an acquired immunodeficiency syndrome (AIDS) . Am J Pathol 1983;;113:382-388.

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