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ARTICLE |

Unexplained Lymphadenopathy in Homosexual Men: Title and subTitle BreakA Longitudinal Study FREE

Daniel B. Fishbein, MD; Jonathan E. Kaplan, MD; Thomas J. Spira, MD; Bess Miller, MD; Lawrence B. Schonberger, MD; Paul F. Pinsky, MPH; Jane P. Getchell, DrPH; Vaniambabi S. Kalyanaraman, PhD; James S. Braude, MD
[+] Author Affiliations

Reprint requests to Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Fishbein).


JAMA. 1985;254(7):930-935. doi:10.1001/jama.1985.03360070068025
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In January 1982, the Centers for Disease Control began a prospective study of unexplained generalized lymphadenopathy syndrome in 78 homosexual or bisexual men. As of Aug 1, 1984, the median durations of lymphadenopathy and enrollment were 29.5 months and 20 months, respectively. Antibodies to human T-cell lymphotropic virus type III/ lymphadenopathy-associated virus were present in 75 (96%) of the study patients. Five (6%) of the patients were diagnosed as having the acquired immunodeficiency syndrome five to 25 months after the onset of lymphadenopathy. At the time of their initial visit, these five patients had lower T-helper cell counts, hematocrits, lymphocyte counts, and pokeweed mitogen stimulation ratios and were more likely to report severe symptoms than patients who did not develop the acquired immunodeficiency syndrome. During 318 follow-up visits, except for the development of the acquired immunodeficiency syndrome in five patients, there has been little change in the initial laboratory and clinical measures of this cohort. Within the follow-up period of this study, the features of lymphadenopathy syndrome have been unremitting for the majority of patients.

(JAMA 1985;254:930-935)

REFERENCES

Miller B, Stansfield SK, Zack MM, et al:  The syndrome of unexplained generalized lymphadenopathy in young men in New York City: Is it related to the acquired immunodeficiency syndrome ? JAMA 1984;;251:242-246.
Barre-Sinoussi F, Chermann J, Rey F, et al:  Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immunodeficiency syndrome . Science 1983;;220:868-871.
Gallo RC, Salahuddin SZ, Popovic M, et al:  Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS . Science 1984;; 224:500-502.
Metroka CE, Cunningham-Rundles S, Pollack MS, et al:  Generalized lymphadenopathy in homosexual men . Ann Intern Med 1983;;99:585-591.
Abrams DI, Lewis BJ, Beckstead JH, et al:  Persistent diffuse lymphadenopathy in homosexual men: Endpoint or prodrome ? Ann Intern Med 1984;;100:801-808.
Mathur-Wagh U, Enlow RE, Spigland I, et al:  Longitudinal study of persistent generalized lymphadenopathy in homosexual men: Relation to acquired immune deficiency syndrome (AIDS) . Lancet 1984;;1:1033-1037.
Jaffe HW, Choi K, Thomas PA, et al:  National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: I. Epidemiologic results . Ann Intern Med 1983;;99:145-151.
Nicholson JKA, McDougal JS, Spira TJ, et al:  Immunoregulatory subsets of the T helper and T suppressor cell populations in homosexual men with chronic unexplained lymphadenopathy . J Clin Invest 1984;;73:191-202.
Chan WC, Check IJ, Heffner LT, et al:  Prolymphocytic leukemia of helper cell phenotype: A report of a case and review of the scientific literature . Am J Clin Pathol 1982;; 77:643-647.
Zubler RH, Lange G, Lambert PH, et al:  Detection of immune complexes in unheated sera by a modified 125I-C1q binding test . J Immunol 1976;;116:232-235.
McDougal JS, Redecha PB, Inman RD, et al:  Binding of immunoglobulin G aggregates and immune complexes in human sera to staphylococci containing protein A . J Clin Invest 1979;; 63:627-636.
Kalyanaraman VS, Cabradilla CD, Getchell JP, et al:  Antibodies to the core protein of lymphadenopathy associated virus (LAV) in patients with AIDS . Science 1984;;225:321-323.
Tsang VCS, Peralta J, Simons AR:  The enzyme-linked immunoelectro-transfer blot techniques (EITB) for studying the specificity of antigens and antibodies separated by gel electrophoresis . Methods Enzymol 1983;;92:377-391.
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profiles . Clin Immunol Immunopathol 1983;;27:315-325.
Klein RS, Harris CA, Small CB, et al:  Oral candidiasis in high risk patients as the initial manifestation of the acquired immunodeficiency syndrome . N Engl J Med 1984;;311:354-358.

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Miller B, Stansfield SK, Zack MM, et al:  The syndrome of unexplained generalized lymphadenopathy in young men in New York City: Is it related to the acquired immunodeficiency syndrome ? JAMA 1984;;251:242-246.
Barre-Sinoussi F, Chermann J, Rey F, et al:  Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immunodeficiency syndrome . Science 1983;;220:868-871.
Gallo RC, Salahuddin SZ, Popovic M, et al:  Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS . Science 1984;; 224:500-502.
Metroka CE, Cunningham-Rundles S, Pollack MS, et al:  Generalized lymphadenopathy in homosexual men . Ann Intern Med 1983;;99:585-591.
Abrams DI, Lewis BJ, Beckstead JH, et al:  Persistent diffuse lymphadenopathy in homosexual men: Endpoint or prodrome ? Ann Intern Med 1984;;100:801-808.
Mathur-Wagh U, Enlow RE, Spigland I, et al:  Longitudinal study of persistent generalized lymphadenopathy in homosexual men: Relation to acquired immune deficiency syndrome (AIDS) . Lancet 1984;;1:1033-1037.
Jaffe HW, Choi K, Thomas PA, et al:  National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: I. Epidemiologic results . Ann Intern Med 1983;;99:145-151.
Nicholson JKA, McDougal JS, Spira TJ, et al:  Immunoregulatory subsets of the T helper and T suppressor cell populations in homosexual men with chronic unexplained lymphadenopathy . J Clin Invest 1984;;73:191-202.
Chan WC, Check IJ, Heffner LT, et al:  Prolymphocytic leukemia of helper cell phenotype: A report of a case and review of the scientific literature . Am J Clin Pathol 1982;; 77:643-647.
Zubler RH, Lange G, Lambert PH, et al:  Detection of immune complexes in unheated sera by a modified 125I-C1q binding test . J Immunol 1976;;116:232-235.
McDougal JS, Redecha PB, Inman RD, et al:  Binding of immunoglobulin G aggregates and immune complexes in human sera to staphylococci containing protein A . J Clin Invest 1979;; 63:627-636.
Kalyanaraman VS, Cabradilla CD, Getchell JP, et al:  Antibodies to the core protein of lymphadenopathy associated virus (LAV) in patients with AIDS . Science 1984;;225:321-323.
Tsang VCS, Peralta J, Simons AR:  The enzyme-linked immunoelectro-transfer blot techniques (EITB) for studying the specificity of antigens and antibodies separated by gel electrophoresis . Methods Enzymol 1983;;92:377-391.
Ammann AJ, Abrams D, Conant M, et al:  Acquired immune dysfunction in homosexual men: Immunologic profiles . Clin Immunol Immunopathol 1983;;27:315-325.
Klein RS, Harris CA, Small CB, et al:  Oral candidiasis in high risk patients as the initial manifestation of the acquired immunodeficiency syndrome . N Engl J Med 1984;;311:354-358.
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