Studies of Lymph Nodes From Patients With Classical Hemophilia

Within the last 1 8 months. we have noted the development of unexplained lymph node enlargement in otherwise asymptomatic patients with hemophilia. Because such changes are poorly understood and, in some patient groups, may be related to the acquired immunodeficiency syndrome (AIDS). we studied the enlarged lymph nodes in four patients with severe factor VIII deficiency and abnor-mally low peripheral blood helper-inducer/suppressor cell (.OKT4/OKT8) ratios. Surgically excised lymph nodes were studied for histopathologic. electron microscopic. and chromosomal changes. Cell suspensions from these and normal nodes were also studied using monoclonal antibod-ies. Excised lymph nodes showed follicular hyperplasia. R ECENTLY, homosexual men and patients with hemophilia have been noted to have chronic lymph node enlargement, abnormal immunologic stud-ies, and occasionally splenomegaly.’3 Because patients with hemophilia may be at risk for acquired immuno-deficiency syndrome (AIDS), and because similar findings have been noted in homosexuals with AIDS, an understanding of these clinical features is impor-tant.4’5 We have previously noted that hemophiliacs with enlarged lymph nodes have greater abnormalities in lymphocyte function than those without such abnor-malities and have joined others in questioning whether this may put them at increased risk for AIDS.3”4’8 With this background, we studied the lymph nodes from four consecutive patients with factor VIII (FVIII) deficiency who were found to develop lymph node enlargement. We compared cell phenotypes, his-topathologic and electron microscopic features, and chromosomal evaluations with those of lymph nodes taken from normal subjects