title: Human T-cell lymphotropic virus type II-associated myelopathy: clinical and immunologic profiles.
abstract: Human T-cell lymphotropic virus type II (HTLV-II) is endemic in several ethnic tribes and among intravenous drug users in metropolitan areas. Despite the presence of HTLV-II in these various populations, the association of HTLV-II with disease is sparse and mainly limited to isolated case reports. This study is an extension of an earlier description of an HTLV-II-infected patient with neurologic disease and presents the clinical and immunologic findings of 4 patients with HTLV-II seropositivity and spastic paraparesis. The patients are of African-American origin with 3 of the patients being of Amerindian descent. All of the patients are seronegative for the human immunodeficiency virus (HIV). The patients progressed to a nonambulatory state in less than 5 years. Magnetic resonance imaging studies obtained from 3 of the patients demonstrated white matter disease in the cerebrum and spinal cord. The cerebrospinal fluid and serum contained antibodies to HTLV-II. The presence of proviral HTLV-II was confirmed by polymerase chain reaction analysis of peripheral blood lymphocytes (PBLs). A spinal cord biopsy from 1 patient demonstrated HTLV RNA within a lesion. Immunologic studies on 2 patients demonstrated that spontaneous lymphoproliferation of PBLs was present but decreased relative to HTLV-I-infected patients. The clinical and immunologic findings from these HTLV-II-infected patient resemble those found in HTLV-I-associated myelopathy/tropical spastic paraparesis.
authors.affiliation: Neuroimmunology Branch, NINDS, NIH, Bethesda, MD 20892, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Lehky
authors.forename: N
authors.initials: N
authors.lastname: Flerlage
authors.forename: D
authors.initials: D
authors.lastname: Katz
authors.forename: S
authors.initials: S
authors.lastname: Houff
authors.forename: W H
authors.initials: WH
authors.lastname: Hall
authors.forename: K
authors.initials: K
authors.lastname: Ishii
authors.forename: C
authors.initials: C
authors.lastname: Monken
authors.forename: S
authors.initials: S
authors.lastname: Dhib-Jalbut
authors.forename: H F
authors.initials: HF
authors.lastname: McFarland
authors.forename: S
authors.initials: S
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D044383:Black People; D001921:Brain / Q000473:pathology / Q000821:virology; D001927:Brain Diseases / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D015482:HTLV-II Antibodies / Q000097:blood; D015491:HTLV-II Infections / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D015367:Human T-lymphotropic virus 2 / Q000302:isolation & purification*; D006801:Humans; D007198:Indians, North American; D008214:Lymphocytes / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D013116:Spinal Cord / Q000473:pathology / Q000821:virology; D013118:Spinal Cord Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*
chemical_list: D015482:HTLV-II Antibodies; D012367:RNA, Viral