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Frank Adams, MD, FRCP(C)
The University of Texas System Cancer Center M. D. Anderson Hospital and Tumor Institute Houston

JAMA. 1984;251(7):891.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

One cannot but wholeheartedly support Holtz et al¹ in their call for more humane understanding and treatment of patients with acquired immune deficiency syndrome (AIDS). However, I am concerned that physicians will overemphasize the psychosocial interpretations of the authors' excellent observation of the "sheet sign," thereby adding medical tragedy to concurrent social injustice.

The authors state that the sheet sign is "an observation as ominous as any pathology report." How right they are, but for the wrong reasons. For many, if not most, of the patients with AIDS I am called to see with these psychosocial lables—and we can include "depression," "self-pity," and "the giving-up syndrome"—turn out to have undiagnosed brain disorders, masquerading as personality, congitive, or affective changes.

Of the patients with AIDS on whom I have consulted with the sheet sign, the final diagnoses in the majority have included herpes simplex and Toxoplasma gondii . . . [Full Text PDF of this Article]

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