Absence of lymphocytic alveolitis in patients with multiple sclerosis.

communications to the editor Communication-c for tl,i.s section will be published as space and priorities permit. The comments should not exceed 350 words in length, wit/i a maximum office refrrences; one figure or table can be printed. Exception.c may occur under particular circumstances. Contributions may include comments on articles published in this periodical, or they II ay be reports of unique educational character Specific permission to publish should be cited in a coeering ktter or appended as a postscript. The differentiation between multiple sclerosis (MS) and human T-cell lymphotropic virus type I (HTLV-I)-associated paraplegia (HAP) is difficult. Clinical guidelines for separating the two entities have been suggested.' Because lymphocytic alveolitis is a frequent finding in HAP patients, an increased number of lymphocytes in bronchoalveolar washings may be suggestive of HAP rather than MS.'3 The aim ofthis study was to determine whether MS patients have lymphocytic alveolitis. We studied six patients (five white, one black; three male, three female). The black patient was a 36-year-old woman from French Guiana. None ofthe patients had abused drugs. None had a previous history of l)lOOd transfusion. All male patients were heterosexual. All patients fulfilled the diagnostic criteria for definite MS.4 No patient presented with paraplegia. In five cases, MS was in remission when bronchoalveolar lavage was performed. One month before studs; the black female patient had had left arm and leg weakness, which improved with corticosteroid therapy. All patients were seronegative for human immunodeficiency virus and IITLV-I on enzyme-linked immunosorbent and Western blot assays. Informed consent was obtained from all patients. Bronchoalveolar lavage was performed as previously reported.2 Patients 1, 2, and 4 were smokers. No patient had pulmonary symptoms or signs, and all patients had normal chest roentgeno-grams. The characteristics of cells recovered by bronchoalveolar lavage are summarized in Table 1. Absolute numbers and proportions of cell yields by bronchoalveolar lavage were normal. We have shown an absence of lymphocytic alveolitis in all MS patients tested. These findings contrast sharply with the high frequency oflymphocytic alveolitis observed in HAP patients.2'3 We agree with the hypothesis of Poser et at' that MS patients have no lymphocytic alveolitis. In endemic areas for HTLV-I infection, determination of the presence of lymphocytic alveolitis may differ-A, Danon F, et al. Bronchoalveolar lymphocytosis in patients with tropical spastic paraparesis associated with human T-cell lympho-tropic virus type 1 (HTLV-I). involvement in patients with HTLV-I associated myelopathy: increased soluble IL-2 receptors …