title: Amyotrophic lateral sclerosis presentation of a human T-lymphotropic virus type-1 myelopathy--insight into pathogenesis.
abstract: A 41-year-old human T-lymphotropic virus type 1-positive woman developed a syndrome with upper and lower motor neuron signs sometime after bilateral vertebral artery dissections. Over 2 years, she developed a progressive myelopathy affecting predominantly the motor system. She had the picture of a 'person in a barrel' and died from complications. At autopsy, spinal cord revealed inflammatory infiltrates and extensive gliosis involving mainly the anterior horns. The vertebral arterial dissections may have permitted the entry of infected lymphocytes and macrophages, secreting cytokines and metalloproteinases, into the medulla progressing to the spinal cord. Few cases with pathological correlation have been reported.
authors.affiliation: Division of Neurology, Department of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.|Division of Neurology, Department of Medicine and Brain Research Centre, UBC Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nuha M
authors.initials: NM
authors.lastname: Alkhawajah
authors.affiliation: Division of Neurology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Chapman
authors.affiliation: Division of Neurology, Department of Medicine and Brain Research Centre, UBC Hospital, University of British Columbia, Vancouver, BC, Canada.|Department of Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.|International Collaboration on Repair Discoveries (ICORD), University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: G R Wayne
authors.initials: GR
authors.lastname: Moore
authors.affiliation: Division of Neurology, Department of Medicine and Brain Research Centre, UBC Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Oger
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000473:pathology* / Q000821:virology*; D001344:Autopsy; D005260:Female; D015368:Human T-lymphotropic virus 1; D006801:Humans; D013116:Spinal Cord / Q000473:pathology / Q000821:virology; D013118:Spinal Cord Diseases / Q000473:pathology* / Q000821:virology*
keywords: Amyotrophic lateral sclerosis; human T lymphotropic virus type 1; pathogenesis