[HTLV-I associated myelopathy with Hashimoto's thyroiditis--a report of two cases]

We reported two cases of HTLV-I associated myelopathy with Hashimoto's thyroiditis. Case 1 is a 47-year-old female, who has had Hashimoto's thyroiditis since the age of 29. At the age of 38, she first noticed difficulty in walking which progressed gradually. At the time of examination, she showed a spastic gait, increased deep tendon reflexes in four extremities, hypesthesia of the feet, mild bowel and bladder disturbances. Anti-HTLV-I antibody was increased to the titer of 16,834 in the serum and of 32 in the cerebrospinal fluid by PA method. Hypothyroidism was present and the titers of microsome test and thyroid test were elevated to 102,400. Anti-T4, and anti-T3, and anti-thyroglobulin antibodies were found. Ultrasonography of the thyroid revealed its enlargement and decreased echo signals. Thyroid scintigram showed inhomogeneous 123I uptake and some defective areas of the uptake. Histological examination of the biopsy specimen of the thyroid demonstrated marked lymphocytic infiltration, germinal centers, hypertrophy of follicular epithelium, and interstitial fibrosis, which were consistent with Hashimoto's thyroiditis. Case 2 is a 60-year-old female who has had slowly progressive gait disturbance since her childhood. She became unable to walk at the age of 35. At the time of examination, she had a spastic gait, increased deep tendon reflexes bilaterally, and positive Babinski signs. Anti-HTLV-I antibodies were increased to a titer of 8,192 in the serum and of 32 in the cerebrospinal fluid. Thyroid function was normal. However, anti-thyroid antibodies were positive and histology of the thyroid showed lymphocytic thyroiditis, which were consistent with mild grade of Hashimoto's thyroiditis.(ABSTRACT TRUNCATED AT 250 WORDS)