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Amyotrophic lateral sclerosis presentation of a human T ‐lymphotropic virus type‐1 myelopathy – insight into pathogenesis
Author(s) -
Alkhawajah Nuha M.,
Chapman Kristine M.,
Moore G. R. Wayne,
Oger Joel
Publication year - 2015
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12422
Subject(s) - medicine , gliosis , myelopathy , spinal cord , pathogenesis , autopsy , pathology , amyotrophic lateral sclerosis , motor neuron , pathological , anatomy , disease , psychiatry
A 41‐year‐old human T ‐lymphotropic virus type 1‐positive woman developed a syndrome with upper and lower motor neuron signs sometime after bilateral vertebral artery dissections. Over 2 years, she developed a progressive myelopathy affecting predominantly the motor system. She had the picture of a ‘person in a barrel’ and died from complications. At autopsy, spinal cord revealed inflammatory infiltrates and extensive gliosis involving mainly the anterior horns. The vertebral arterial dissections may have permitted the entry of infected lymphocytes and macrophages, secreting cytokines and metalloproteinases, into the medulla progressing to the spinal cord. Few cases with pathological correlation have been reported.