Demyelinating changes in sural nerve biopsy of patients with HTLV-I-associated myelopathy.
We describe the sural nerve pathology in 3 patients with HTLV-I-associated myelopathy (HAM). These patients showed remarkable symptoms of myelopathy and had high HTLV-I titers in the serum and CSF. The common pathologic findings in the sural nerves were as follows: slightly decreased density in myelinated fibers (6,567/mm2, 6,488/mm2, and 7,159/mm2; control 9,999 +/- 3,446/mm2), frequent occurrence of demyelinated and remyelinated fibers, and many degenerating fibers with globule-like myelin changes. Teased-fiber analysis indicated the globule-like changes (Dyck's G change) to be accompanied by the formation of adjacent demyelinated segments. The globules result from slowly repetitive degenerative changes of myelin and are considered to be a form of demyelination. However, they have seldom been found in other demyelinating neuropathies, indicating the demyelination process with globule formation in HAM to be rather specific for this disease.
Sugimura
K
K
Department of Neurology, Nagoya University School of Medicine, Japan.
Takahashi
A
A
Watanabe
M
M
Mano
K
K
Watanabe
H
H
D001369:Axons / Q000648:ultrastructure; D001706:Biopsy; D003711:Demyelinating Diseases / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D015481:HTLV-I Antibodies / Q000032:analysis; D015490:HTLV-I Infections / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009186:Myelin Sheath / Q000473:pathology / Q000648:ultrastructure; D009431:Neural Conduction; D013127:Spinal Nerves / Q000473:pathology*; D013497:Sural Nerve / Q000473:pathology* / Q000648:ultrastructure
D015481:HTLV-I Antibodies