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[A family case of HAM and HTLV-I carrier including two sisters presenting with myositis]
Insights
This study presents a family case of Human T-lymphotropic virus type I (HTLV-I) infection and associated myelopathy (HAM) in two sisters with myositis. The findings suggest a potential link between HTLV-I and polymyositis.
Area of Science:
- Neurology
- Infectious Diseases
- Rheumatology
Background:
- Human T-lymphotropic virus type I (HTLV-I) is associated with several neurological disorders, including HTLV-I-associated myelopathy (HAM).
- Polymyositis is an inflammatory myopathy characterized by muscle weakness and inflammation.
Observation:
- Two sisters, aged 65 and 53, presented with a history of lumbago and progressive difficulty in walking.
- Neurological examination revealed proximal muscle weakness, hyperreflexia, urinary disturbance, and constipation.
- Both sisters tested positive for anti-HTLV-I antibodies in serum and cerebrospinal fluid (CSF).
Findings:
- Muscle biopsies demonstrated features consistent with myositis, including perivascular, perimysial, and endomysial lymphocyte infiltration.
- The clinical presentation and biopsy findings in both sisters suggest an inflammatory myopathy.
- The presence of HTLV-I infection in both affected individuals supports a potential etiological role.
Implications:
- These cases provide further evidence supporting an association between HTLV-I infection and polymyositis.
- Further research is warranted to elucidate the mechanisms by which HTLV-I may contribute to inflammatory myopathies.
- This study highlights the importance of considering HTLV-I in the differential diagnosis of myositis, particularly in endemic areas.
Abstract:
We reported a family case of HAM and HTLV-I carrier including two sisters presenting with myositis. Both the 65-year-old elder sister and her 53-year-old younger sister initially noted lumbago and developed difficulty in walking several years later. Neurologic examination revealed muscle weakness of the proximal parts of the upper and lower limbs (especially the latter). Mild hyperreflexia in all extremities, urinary disturbance and constipation were detected in the elder sister, while only urinary disturbance and constipation were seen in the younger. Anti-HTLV-I antibody in both serum and CSF was positive in both sisters. Muscle biopsy specimens showed features of myositis with perivascular, perimysial and endomysial lymphocyte infiltration. Although an association between HTLV-I and polymyositis had not yet been established, we think that our cases support such an association.