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[HTLV-I-associated neuropathy]

A Kanzaki¹, S Yabuki, T Shirabe

¹Department of Neurology, Kochi Municipal Central Hospital, Japan.

No to Shinkei = Brain and Nerve

|May 1, 1995

Summary

This study details a 70-year-old man with progressive neurological symptoms, ultimately diagnosed with Human T-lymphotropic virus type I (HTLV-I) infection of the HAM type, presenting primarily as neuropathy.

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Area of Science:

Neurology
Infectious Diseases
Immunology

Background:

Human T-lymphotropic virus type I (HTLV-I) infection can cause neurological disorders.
The clinical spectrum of HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) is variable.

Observation:

A 70-year-old man presented with a 15-year history of walking difficulty, sensory disturbances, and tremors.
Physical examination revealed muscle fasciculations, atrophy, weakness, and sensory deficits.
Electrophysiological and nerve/muscle biopsy studies indicated a mixed axonal and demyelinating neuropathy with neurogenic changes and T-cell infiltration.

Findings:

Laboratory tests confirmed positive anti-HTLV-I antibodies, ATL-like cells in blood and CSF, and HTLV-I provirus DNA.
The patient's HLA type was consistent with HAM.
Despite positive HTLV-I markers, the absence of pyramidal signs led to a diagnosis other than classic HAM/TSP, focusing on the predominant neuropathy.

Implications:

This case highlights the diverse neurological presentations of HTLV-I infection.
It underscores the importance of considering HTLV-I in patients with unexplained peripheral neuropathy, even without typical myelopathy signs.
Further research may elucidate the specific mechanisms driving neuropathy in HTLV-I-infected individuals.

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