An acute polyradiculoneuritis with tetraplegia and respiratory failure was observed in a 27 year-old heroin addict 3 hours after an intravenous injection of heroin. Full recovery was obtained after respiratory assistance and plasma exchanges. The biological and morphological changes (sural nerve biopsy) suggested an immune mediated mechanism. Three years after the recovery, the patient was tested for HIV antibody and was seropositive. The role of HIV infection and of the injection of heroin are discussed.