Sarcoidosis and HTLV-1 infection.
An asymptomatic, homosexual, white man was found to have an abnormal chest x ray. A presumptive diagnosis of sarcoidosis was made, but pulmonary function tests and a transbronchial biopsy were normal. He then remained asymptomatic for 10 years until he developed a progressive spastic paraparesis. At this point, antibodies to human T cell lymphotropic virus type 1 (HTLV-1) were identified in the serum and cerebrospinal fluid, and the diagnosis of HTLV-1 associated myelopathy was made, the history suggesting sexual exposure to HTLV-1 many years previously. HTLV-1 is associated with a spectrum of immune related disorders, including a pulmonary sarcoid-like syndrome. Infection with this chronic proinflammatory retrovirus should be considered in the differential diagnosis of all immune disorders in at risk individuals.
McKee
D H
DH
Department of Neurology, Greater Manchester Centre for Clinical Neurosciences, Hope Hospital, Stott Lane, Salford M6 8HD, UK. david@mckee490.freeserve.co.uk
Young
A C
AC
Haeney
M
M
D015490:HTLV-I Infections / Q000150:complications* / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging / Q000821:virology*