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Letters |1 June 1995

Neurologic Manifestations of HIV Infection

Raphael B. Stricker

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TO THE EDITOR:
Simpson and Tagliati [1] have provided an excellent and thorough review of the neurologic manifestations of HIV infection. The review fails, however, to mention one treatable cause of HIV-related peripheral neuropathy: cryoglobulinemia.
Type III (polyclonal) cryoglobulinemia has been associated with polyneuropathy and mononeuritis multiplex in two patients with HIV disease [2-4]. Neither patient was infected with hepatitis C virus [3, 4], and HIV was the only identifiable etiologic agent in each case. The neuropathy appeared to improve with plasmapheresis or zidovudine therapy [2, 4], although spontaneous neurologic improvement could not be excluded.
The true incidence of cryoglobulinemic neuropathy in HIV disease remains unknown. Because testing for cryoglobulins is not routinely done in HIV-infected patients, the role of cryoglobulinemia in HIV-related peripheral neuropathy may be greater than is suspected.
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Stricker RB. Neurologic Manifestations of HIV Infection. Ann Intern Med. ;122:883–884. doi: 10.7326/0003-4819-122-11-199506010-00027

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Published: Ann Intern Med. 1995;122(11):883-884.

DOI: 10.7326/0003-4819-122-11-199506010-00027

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