Chronic progressive cervical myelopathy with HTLV-I infection: Variant form of HAM/TSP?
OBJECTIVE
To investigate the role of human T-lymphotrophic virus type I (HTLV-I) infection in four patients who developed slowly progressive myelopathy with abnormal MRI lesions in the cervical cord levels.


METHODS
Clinical and neuroradiologic examinations were performed, and the odds that an HTLV-I-infected individual of specified genotype, age, and provirus load had HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP) were calculated.


RESULTS
Anti-HTLV-I antibodies were positive in both the serum and the CSF in all of the patients. Biopsied sample from spinal cord lesions showed inflammatory changes in Patient 1. Patient 2 had a demyelinating type of sensorimotor polyneuropathy. Two of the three patients examined showed high risk of developing HAM/TSP in virologic and immunologic aspects.


CONCLUSIONS
These four cases may belong to a variant form of HAM/TSP, predominantly involving the cervical cord levels.
Department of Neurology, Graduate School of Kagoshima University, Sakuragaoka 8-35-1, Kagoshima 8900075, Japan. umehara@m2.kufm.kagoshima-u.ac.jp
F
F
Umehara
S
S
Nagatomo
K
K
Yoshishige
M
M
Saito
Y
Y
Furukawa
K
K
Usuku
M
M
Osame
D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D005838:Genotype; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009333:Neck; D015493:Paraparesis, Tropical Spastic / Q000134:cerebrospinal fluid / Q000145:classification* / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D011115:Polyneuropathies / Q000150:complications; D011336:Probability; D013116:Spinal Cord / Q000473:pathology*
D003287:Contrast Media; D019786:Gadolinium DTPA