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CD8 and CD4 T cell‐mediated polymyositis complicating the HTLV‐1 associated myelopathy. Quantitative evaluation of corticosteroid treatment
Author(s) -
Waclawik A. J.,
Fadic R.,
Lotz B. P.,
Beinlich B. R.,
Lewandoski P. J.,
Sanjak M.,
Brooks B. R.
Publication year - 1996
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1996.tb07040.x
Subject(s) - polymyositis , medicine , muscle biopsy , prednisone , myalgia , biopsy , muscle weakness , creatine kinase , myelopathy , methylprednisolone , corticosteroid , pathology , myositis , electromyography , atrophy , myopathy , spinal cord , psychiatry
– Inflammatory myopathy is a treatable cause of worsening in the spectrum of neurological conditions that may develop during the course of HTLV‐1 infection. Material and methods — To investigate the cause of subacute worsening in the strength of a 46‐y‐old black male with HTLV‐1 associated myelopathy we performed electrodiagnostic examination and a muscle biopsy which was studied with histochemistry, immunocytochemistry and electron microscopy. Serial measurements of isometric muscle strength were performed during the course of corticosteroid treatment. Results — The muscle biopsy showed evidence of denervation atrophy and prominent inflammatory changes with autoaggressive features. Lymphocyte typing showed a predominance of CD8+ T cells. The patient had sustained, marked improvement in strength, especially of the upper extremities, with oral, high single‐dose, alternate‐day prednisone therapy. Conclusion — A muscle biopsy should be considered in all patients with HTLV‐1 associated weakness, especially when electromyography indicates possible coexisting primary muscle involvement and/or serum creatine kinase levels are elevated. HTLV‐1‐associated polymyositis can be successfully treated with corticosteroids.