Subacute “poliomyelitis” and Hodgkin's disease

Abstract

The case is presented of a 44-year-old man who had suffered from Hodgkin's disease for 22 months prior to his death. During the last 3 months of his life he developed progressive muscular weakness and wasting beginning in the proximal muscles of the left upper and lower limbs, but later spreading to involve all of the musculature of both lower extremities and of the left arm and forearm, with less severe involvement of the right upper limb. Post mortem examination demonstrated widespread degeneration of anterior horn cells at many levels of the spinal cord, including some not previously subjected to radiotherapy; there were striking inflammatory infiltrates in and around the degenerated anterior horn cells and the histological changes were pathologically similar to those of acute anterior poliomyelitis. Electron microscopic examination of sections obtained from anterior horn cell regions demonstrated viral-like particles but in this material it was impossible to prove their viral origin. It is suggested that the patient was almost certainly suffering from a virus infection causing progressive degeneration of anterior horn cells in the spinal cord and complicating his Hodgkin's disease.