[A case of HTLV-1 associated myelopathy with pulmonary involvement]

A 70-year-old woman was admitted complaining of gait disturbance and difficulty in urination. Neurological examination showed myelopathy and both serum and CSF anti ATLA antibodies were positive. A diagnosis of HTLV-associated myelopathy (HAM) was made and steroid therapy was initiated. Chest X-ray film on admission showed no abnormality, but three months later, diffuse fine nodular and reticular shadows appeared in both lung fields. The patients had no respiratory symptom. The results of pulmonary function tests were normal, aside from a mild obstructive defect as indicated by reduced V25. Arterial blood gas was also normal. Bronchoalveolar lavage studies showed increased total cell counts and an increased proportion of T-cells. The histological findings of the transbronchial lung biopsy specimen were bronchiolitis and alveolitis. Subsequently, within the next eight months the abnormal shadows on chest X-ray cleared gradually on maintenance dosage of prednisolone, 10 mg/day. Possible relationships between HAM and the pulmonary lesions were discussed.