T-CELL-MEDIATED GANGLIONITIS ASSOCIATED WITH ACUTE SENSORY NEURONOPATHY

A 67-year-old man presented with acute painful sensory loss, areflexia , ataxia, urinary retention, and severe constipation and became unable to walk within 2 weeks. He died suddenly 5 weeks after the onset of s ymptoms. Autopsy revealed widespread inflammation of sensory and auton omic ganglia with immunocytochemical evidence of a CD8(+) T cell-media ted cytotoxic attack against ganglion neurons. This observation sugges ts a novel pathogenetic mechanism of immune-mediated human ganglion ce ll damage comparable to mechanisms operating in polymyositis.