Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

LetterLetter

Adenoid Enlargement and CD4 Counts in HIV-Positive Patients

James L. Fleckenstein
American Journal of Neuroradiology June 1999, 20 (6) 1186-1187;
James L. Fleckenstein
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
Loading

We read with interest the article by Yousem et al in which the size of adenoids in 21 HIV-positive patients was studied as a function of other clinical parameters (1). We are interested in this topic because our experience indicates that large adenoids usually are seen in patients with relatively high CD4 counts. We, therefore, were surprised to learn that Yousem et al's study reported no significant correlation between the number of CD4 antigens and adenoid size. This was particularly surprising because their results were in apparent conflict with the findings reported by Zadanski et al of 33 HIV-positive patients (2). Because of the differing conclusions, we studied 107 HIV-positive patients at our institution to summarize our experience, and to attempt to understand what factors may underlie the apparently disparate results of these other two studies.

Adenoid diameters were measured on sagittal T1-weighted brain MR images, and correlated with CD4 counts in the same manner described by Yousem et al (1). Correlations were recalculated after clustering the data by adenoid size (< 5 mm, 5–7 mm, 8–12 mm, and > 12 mm), similar to the approach used by Zadanski et al. When analyzed, using Yousem's approach, our data similarly indicated no significant correlation between adenoid size and CD4 counts. When analyzed, using Zagdanski's technique, the data suggested a positive correlation between size and CD4 counts (r = 0.84), supporting the conclusions of those authors. Thus, our data support both opposing conclusions, depending on the technique used to analyze the data. Nonetheless, important deficiencies exist in both of these techniques, which when resolved, permit a reasonable understanding of the relationship between CD4 counts and adenoid size.

Using the method employed by Zagdanski, all data are compressed into only four data points. By compressing the 107 observations into four “pseudo observations,” the inherent variability of the data set is lost, limiting the ability to assess errors or trends. Also, the selection of four groups is arbitrary and allows for artificially easy linear regression line fitting. After all, it would be impossible not to find a high correlation had only two groups been selected. Finally, there is no weighting to account for the large variation in the number of patients assigned to each group.

Although Yousem's approach importantly retains the intersubject variation inhererent to the data set, inspection of the resulting regression plot indicates that, for many adenoid sizes, CD4 counts do not distribute normally about the regression line (Fig 1A). Because testing associated with standard linear regression analysis assumes a normal distribution of data, an F test (and significance testing) is inappropriate for the data set in question until a normalizing transformation is made.

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint

To normalize the data distribution, the log of CD4 counts was plotted against adenoid size. Using this transformation, the data points distribute symmetrically about the regression lines (Fig 1B), and modest correlation is obtained that is highly significant (r = .38; P < .0001). Thus, the data support the notion that adenoid size correlates with CD4 counts.

Our analysis of a relatively large group of patients also helps resolve the apparent conflict between the previous studies. The study supports Yousem et al's conclusion that there is not a simple linear relationship between adenoid size and CD4 counts in HIV disease, but we have refined the viewpoint. At the same time, our data support the view of Zagdanski et al that intense adenoid “hypertrophy” tends to occur in patients with relatively high CD4 counts.

References

  1. 7.↵
    Yousem DM, Loevner LA, Tobey JD, et al. Adenoidal width and HIV factors. AJNR Am J Neuroradiol 1997;18:1721-1725
    Abstract
  2. 8.↵
    Zagdanski A, Cyna-Gorse F, De kerviler E, Feger C, Molina J, Fuja J. Correlation between nasophayrngeal pattern at CT and CD4 lymphocyte count in HIV-positive patients. Radiology 1995;197(suppl):346
  • Copyright © American Society of Neuroradiology
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology
Vol. 20, Issue 6
1 Jun 1999
  • Table of Contents
  • Index by author
Advertisement
Print
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Adenoid Enlargement and CD4 Counts in HIV-Positive Patients
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
James L. Fleckenstein
Adenoid Enlargement and CD4 Counts in HIV-Positive Patients
American Journal of Neuroradiology Jun 1999, 20 (6) 1186-1187;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
Adenoid Enlargement and CD4 Counts in HIV-Positive Patients
James L. Fleckenstein
American Journal of Neuroradiology Jun 1999, 20 (6) 1186-1187;
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Letter to the Editor regarding “Automated Volumetric Software in Dementia: Help or Hindrance to the Neuroradiologist?”
  • Reply:
  • Brain AVM’s Nidus: What if We Hadn’t Understood Anything?
Show more Letter

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire