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Chronic progressive myelopathy associated with elevated antibodies to human T‐lymphotropic virus type I and adult T‐cell leukemialike cells
Author(s) -
Osame Mitsuhiro,
Matsumoto Makoto,
Usuku Koichiro,
Izumo Shuji,
Ijichi Naomi,
Amitani Hiroyoko,
Tara Mitsutoshi,
Igata Akihiro
Publication year - 1987
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410210203
Subject(s) - myelopathy , medicine , cerebrospinal fluid , antibody , western blot , t cell , pathology , immunology , titer , tropical spastic paraparesis , virus , t cell leukemia , spinal cord , biology , biochemistry , immune system , psychiatry , gene
Six adult patients had a chronic progressive myelopathy that possessed the following features: (1) high antibody titers to human T‐lymphotropic virus type I (HTLV‐I) in serum and cerebrospinal fluid (CSF); (2) predominantly upper motor neuron disorder, symmetrical, with mild sensory and bladder disturbances; and (3) presence of adult T‐cell leukemia–like cells in both peripheral blood and CSF. We refer to this entity as HTLV‐I–associated myelopathy (HAM). Electrophoretic studies of immunoglobulin G in CSF using Western blot analysis characteristically demonstrated p24 and p32 bands. Rates of intra‐blood–brain barrier synthesis were determined and found increased in the patients with HAM. Corticosteroid treatment produced clinical improvement in all of 4 patients. A retrospective survey of CSF samples was carried out in 287 patients with neurological disorders, and 6 additional patients with HAM were identified.