HTLV-I-associated myelopathy: clinicopathologic correlation with localization of provirus to spinal cord.
A 49-year-old South African man developed a rapidly progressive myelopathy 14 months after blood transfusion and died 1 year after the onset of symptoms. Detailed pathologic examination of the spinal cord was consistent with the diagnosis of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Although no HTLV-I viral particles, antigens, or nucleic acids were detected in situ, polymerase chain reaction assays revealed HTLV-I proviral DNA in cervical, thoracic, and lumbar levels of the spinal cord, with the greatest amount being detected at the thoracic level. These findings suggest that the pathogenesis of HAM/TSP depends on direct infection of neural or immune elements within the spinal cord.
Bhigjee
A I
AI
Department of Medicine, University of Natal, South Africa.
Wiley
C A
CA
Wachsman
W
W
Amenomori
T
T
Pirie
D
D
Bill
P L
PL
Windsor
I
I
D004279:DNA, Viral / Q000032:analysis; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000382:microbiology / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification*; D013116:Spinal Cord / Q000382:microbiology / Q000473:pathology; D013118:Spinal Cord Diseases / Q000382:microbiology* / Q000473:pathology*
D004279:DNA, Viral