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Published on: May 19, 2020
Abnormal spinal MRI findings in human T-cell lymphotrophic virus type I-associated myelopathy
Fumio Yamamoto1, Satoshi Yamashita, Akiko Yamamura
1Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-0811, Japan.
Abstract:
We describe three cases of HTLV-I-associated myelopathy (HAM) with abnormal spinal magnetic resonance imaging (MRI) findings. The serum and cerebrospinal fluid (CSF) of all 3 patients tested positive for anti-HTLV-I antibody. Swelling of the spinal cord with high-intensity lesions on T2-weighted images was observed. Corticosteroid treatment in the case of two patients gradually improved the symptoms, decreased the protein and IgG levels as well as the cell count, and reduced the abnormal MRI findings. To confirm the assumption that abnormal spinal MRI findings are reflective of active inflammation, we compared the clinical parameters, namely, the protein content, IgG level, and cell count, in the CSF of patients exhibiting abnormal spinal MRI findings with those in the case of patients without spinal MRI lesions. The protein contents, IgG levels, and number of cells in the CSF of patients with MRI lesions were significantly higher than those in the CSF of patients without lesions. These findings support the fact that abnormal MRI findings in the spinal cord may be reflective of active inflammation in the early stages of rapidly progressive HAM.
Insights
Abnormal spinal MRI findings in Human T-lymphotropic virus type 1-associated myelopathy (HAM) indicate active inflammation. Treatment with corticosteroids improved symptoms and reduced MRI abnormalities, supporting their role in managing HAM.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Human T-lymphotropic virus type 1 (HTLV-I) can cause HTLV-I-associated myelopathy (HAM), a neurological disorder.
- Spinal magnetic resonance imaging (MRI) is used to assess neurological damage.
Observation:
- Three HAM patients presented with abnormal spinal MRI findings, including spinal cord swelling and T2-weighted high-intensity lesions.
- Serum and cerebrospinal fluid (CSF) tested positive for anti-HTLV-I antibodies in all cases.
Findings:
- Corticosteroid treatment in two patients led to symptom improvement, reduced CSF protein, IgG, and cell counts, and diminished MRI abnormalities.
- Patients with abnormal spinal MRI findings showed significantly higher CSF protein, IgG levels, and cell counts compared to those without lesions.
- Abnormal spinal MRI findings correlate with active inflammation in early-stage, rapidly progressive HAM.
Implications:
- Spinal MRI findings are valuable indicators of active inflammation in HAM.
- These findings support the use of MRI in diagnosing and monitoring HAM progression.
- Early detection of inflammation through MRI may guide timely therapeutic interventions for HAM patients.
