[HTLV-I-associated neuropathy].
A 70-year-old man was admitted to our hospital because of a 15-year history of walking difficulty, disturbance of sensation in the palm for 2 years and hand tremor for 6 months. On admission, the scapulohumeral muscles showed fasciculation and atrophy. There was action tremor in the upper limb, and the proximal lower limb showed atrophy and weakness. Standing and walking were impossible. Deep tendon reflexes were decreased in lower limbs. Pathologic reflexes were not found. There was distal dominant sensory disturbance, and urination was difficult. Needle EMG showed a neurogenic pattern in 4 all limbs. MCV and F-latency were delayed. SCV in the median nerve and the amplitude in the sural nerve were decreased. Biopsy of the sural nerve revealed both axonal change and demyelination. Biopsy of the quadriceps femoris muscle showed neurogenic change with helper T-cell infiltration. Anti-HTLV-I antibody and ATL-like cells in both blood and CSF were positive. There were HTLV-I provirus DNA with a polyclonal pattern and the type of HLA as HAM. The HTLV-I infection was of the HAM type. As the present patient showed mainly neuropathy without pyramidal signs, was not considered to have HAM.
Kanzaki
A
A
Department of Neurology, Kochi Municipal Central Hospital, Japan.
Yabuki
S
S
Shirabe
T
T
D000368:Aged; D001369:Axons / Q000473:pathology; D004279:DNA, Viral / Q000032:analysis; D003711:Demyelinating Diseases / Q000209:etiology; D015481:HTLV-I Antibodies / Q000032:analysis; D015490:HTLV-I Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology* / Q000473:pathology
D004279:DNA, Viral; D015481:HTLV-I Antibodies