title: Abnormalities of spinal magnetic resonance images implicate clinical variability in human T-cell lymphotropic virus type I-associated myelopathy.
abstract: This study investigated the role of human T-cell lymphotropic virus type I HTLV-I infection in 11 patients who developed slowly progressive myelopathy with abnormal spinal cord lesions. The authors performed clinical and neuroradiological examinations and calculated the odds that an HTLV-I-infected individual of a specific genotype, age, and provirus load has HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Anti-HTLV-I antibodies were present in both the serum and cerebrospinal fluid in all of the patients. Abnormal magnetic resonance imaging (MRI) lesions were classified as cervical to thoracic type (CT type), cervical type (C type), and thoracic type (T type). In each type, there was swelling of the spinal cords with high-intensity lesions, which were located mainly in bilateral posterior columns, posterior horns, or lateral columns. Virological and immunological analyses revealed that all patients showed a high risk of developing HAM/TSP. These 11 patients may have developed HAM/TSP, as manifested by spinal cord abnormalities shown on MRI. These MRIs implicate clinical variability of HAM/TSP, which may indicate active-early stages of HAM/TSP lesions.
authors.affiliation: Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. umehara@m2.kufm.kagoshima-u.ac.jp
authors.forename: Fujio
authors.initials: F
authors.lastname: Umehara
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Nose
authors.forename: Mineki
authors.initials: M
authors.lastname: Saito
authors.forename: Michinari
authors.initials: M
authors.lastname: Fukuda
authors.forename: Mieko
authors.initials: M
authors.lastname: Ogino
authors.forename: Tomoko
authors.initials: T
authors.lastname: Toyota
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yuhi
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Arimura
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Osame
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D002574:Cervical Vertebrae; D004487:Edema / Q000473:pathology / Q000821:virology; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000473:pathology* / Q000821:virology*; D015493:Paraparesis, Tropical Spastic / Q000276:immunology / Q000473:pathology*; D020671:Posterior Horn Cells / Q000473:pathology / Q000821:virology; D013904:Thoracic Vertebrae
chemical_list: D000914:Antibodies, Viral