title: Human T-lymphotropic virus type-I (HTLV-I)-associated myelopathy with bulbar palsy-type amyotrophic lateral sclerosis-like symptoms.
abstract: We herein report a case of Human T-lymphotropic virus type-I (HTLV-I)-associated myelopathy with bulbar palsy-type amyotrophic lateral sclerosis-like symptoms. A 52-year-old woman developed dyslalia at approximately 40 years of age, which slowly progressed. She presented with muscular atrophy and increased tendon reflexes of the extremities as well as bulbar palsy, from which motor neuron disease was suspected. Cerebrospinal fluid (CSF) testing revealed no abnormalities except for an elevated neopterin concentration at 143.17 pmol/mL (normal ≤30 pmol/mL). Her serum and CSF anti-HTLV-I antibody titers were also high. Intravenous infusions of methylprednisolone decreased the CSF neopterin concentration to 50.33 pmol/mL. Subsequent oral prednisolone therapy was effective in alleviating the symptoms.
authors.affiliation: Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Ando
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishikawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tsujii
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwaki
authors.forename: Hayato
authors.initials: H
authors.lastname: Yabe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nagai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nomoto
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000276:immunology*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D010244:Bulbar Palsy, Progressive / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D015481:HTLV-I Antibodies / Q000097:blood; D015368:Human T-lymphotropic virus 1 / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D009133:Muscular Atrophy / Q000276:immunology* / Q000503:physiopathology; D015493:Paraparesis, Tropical Spastic / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D011239:Prednisolone / Q000008:administration & dosage*; D012021:Reflex, Abnormal; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D015481:HTLV-I Antibodies; D011239:Prednisolone