[Migrating radiculopathy--an unusual complication of systemic lupus erythematosus in an HTLV-1 carrier].
We reported a 54-year-old HTLV-I seropositive female patient with systemic lupus erythematosus (SLE), who developed migrating radiculopathy but without chronic progressive myelopathy. She occasionally noticed butterfly rash and photosensitivity of the skin as well as painful episodes in different joints for 10 years. She developed pins and needles sensation on her trunk a few days after she experienced lumbago with abrupt onset. Neurological examinations revealed normal muscular strength, exaggerated deep tendon reflexes without Babinski signs, and dysesthesia on her upper extremities and the trunk. The latter symptom showed a segmental distribution of spinal nerve roots. And during the course of the disease, it migrated in accord with a radicular pattern. This sensory disturbance was fairly responsive to corticosteroid treatment. The spinal tap yielded clear cerebrospinal fluid (CSF) which showed mononuclear pleocytosis (16/mm3) with predominance of CD8+ cytotoxic cells and a positive result for anti-HTLV-I antibody. A neurological status deteriorated in parallel with non-neurological symptoms as SLE, when the patient had discontinued corticosteroids in a tapering course by herself. We postulate that HTLV-I infection in this patient modulated original autoimmune reactions as SLE, which led to manifestation of migrating radiculopathy possibly due to autoimmunity against ganglion cells. This is, to our knowledge, the first report of migrating radiculopathy in an SLE patient associated with HTLV-I infection.
Kondo
T
T
Department of Neurology, Wakayama Redcross Hospital.
Matsui
M
M
D002353:Carrier State; D005260:Female; D015481:HTLV-I Antibodies / Q000097:blood*; D015490:HTLV-I Infections / Q000150:complications*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008875:Middle Aged; D011843:Radiculopathy / Q000209:etiology*
D015481:HTLV-I Antibodies