Lymph node pathology in infants of HTLV-I seropositive mothers - abstract

ABSTRACT

In a cohort of seronegative mother-infant pairs being studied for perinatal transmission of the human T-lymphotropic virus type (HTLV-I), it was noticed that some infants developed persistent lymphadenopathy for which no specific cause was apparent. In order to determine whether this lymphadenopathy reflected a specific lymphoreticular abnormality, the lymph node pathology was studied, using morphological and immunohistochemical methods. Of 17 infants with lymphadenopathy, 16 were from seropositive mothers. Twenty-four infants (7.0 percent) in the cohort group seroconverted. Only 4 of these were infants with lymphadenopathy. Seroconversion in these tended to occur later than in infants without lymphadenopathy (mean 12 months; range 10 - 18 months). The lymph node histology showed non-specific reactive hyperplasia with a predominance (14/15) of mixed and paracortical hyperplasia. On immunohistochemistry, CD25 staining, characteristic of neoplastic transformation by HTLV-I, was positive in 6/11 cases but without correlation with seropositivity in these infants. This pattern of hyperplasia is unusual in infancy. As in HIV-induced lymphodenopathy, although the changes are not specific, they are sufficiently distinctive, particularly in HTLV-I endemic areas, to warrant serological testing of infants and mothers. The immune reponse without seroconversion appears aberrant. (AU)