Endoneurial vasculitis and tubuloreticular inclusions in peripheral nerve biopsy

We describe 3 patients in whom nerve biopsy revealed endothelial tubuloreti cular inclusions in association with peripheral nerve endoneurial vasculiti s. Two of the patients had systemic lupus erythematosus (SLE), while the th ird was HIV-positive. Review of our biopsy material featuring the much more common finding of epineurial vasculitis failed to disclose any instances i n which endothelial tubuloreticular inclusions (TRIs) were present. We conc lude that TRIs and endoneurial vasculitis are closely associated. Moreover, if detected on a nerve biopsy specimen, TRIs are very suggestive of SLE or HIV infection. Finally, literature evidence is cited to suggest that an "a cid-labile" a-interferon may be pathogenically related to the vasculitic pr ocess in these patients, perhaps through a process mediated by tumor necros is factor.