Postpartum exacerbation of HTLV-I associated myelopathy/tropical spastic paraparesis followed by an episode of painless thyroiditis.
A 28-year-old woman noticed a progressive gait disturbance after her first delivery. At the age of 32, the gait disturbance improved during her second pregnancy, but became worse after delivery and eventually resulted in a scissoring gait. At the age of 34, she became transiently thyrotoxic and was diagnosed as having painless thyroiditis and HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP). The findings of this case suggest that the postpartum exacerbation of HAM/TSP was probably due to a rebound phenomenon after immunosuppression during pregnancy, and that the immunological abnormalities associated with HAM/TSP might have played some role in the development of painless thyroiditis.
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka.
T
T
Mizokami
K
K
Okamura
K
K
Sato
T
T
Kuroda
Y
Y
Itoyama
M
M
Fujishima
D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D015995:Prevalence; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D013966:Thyroiditis / Q000175:diagnosis* / Q000276:immunology