Acute myelopathy and cerebellar signs associated with uveitis with positive serum and cerebrospinal fluid antibodies to HTLV-I.
A 55-year-old man was admitted because of weakness in the legs of a few days duration. Neurological examination revealed paraparesis, ataxia of the left limbs, superficial hypoesthesia below the T-10 dermatome level and urinary retention. The antibody titers to human T-lymphotropic virus type I (HTLV-I) were x640 in the serum and x16 in the cerebrospinal fluid (CSF). The HTLV-I gag proteins, p19, p24, p46 and p53 were identified by Western blotting analysis of the serum and CSF. The CSF contained 691 white cells/c.mm; protein, 260 mg/dl; IgG, 84 mg/dl; and IgG index, 2.49. Although the paraparesis and urinary retention disappeared within 10 days, he developed right uveitis which responded well to corticosteroid treatment. With improvement of the sensory impairment, cerebellar signs and CSF pleocytosis as well as uveitis, he was discharged eight weeks after admission. HTLV-I uveitis is a recently established disease entity. The case emphasizes the need to test blood and CSF for HTLV-I antibodies if patients developed myelopathy and cerebellar signs of acute onset, especially when associated with uveitis.
Sato
Y
Y
Department of Neurology, Futase Social Insurance Hospital, Iizuka, Japan.
Honda
Y
Y
Ohshima
Y
Y
Honda
E
E
Oizumi
K
K
Takeuchi
N
N
D002531:Cerebellum / Q000473:pathology; D015481:HTLV-I Antibodies / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications / Q000276:immunology* / Q000473:pathology; D014605:Uveitis / Q000150:complications / Q000276:immunology* / Q000473:pathology
D015481:HTLV-I Antibodies