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HTLV‐I associated myelopathy in a Seychellois immigrant
Author(s) -
Thyagarajan Dominic,
Bastian Ivan,
Stark Richard J,
Day Bruce J,
Dax Elizabeth M,
Gilligan Bernard S
Publication year - 1993
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1993.tb137701.x
Subject(s) - myelopathy , medicine , asymptomatic , disease , immunology , human leukocyte antigen , etiology , virology , antigen , spinal cord , psychiatry
Objective To describe the clinical and laboratory features of human T‐lymphotropic virus type I (HTLV‐I) associated myelopathy in an immigrant from the Seychelles. Clinical features A slowly progressive myelopathy has been recently diagnosed in a 64‐year‐old woman who emigrated to Australia from the Seychelles in 1957. Sphincter disturbance and back pain were the first manifestations, followed by gait disturbance. Neurophysiological investigation supported the clinical diagnosis of a myelopathy and radiological investigations revealed no structural cause. Serum antibodies to HTLV‐I were detected by enzyme‐linked particle agglutination and the presence of antibodies to individual HTLV‐I gene products in the serum was confirmed by western blot. The virus was detected in a culture of the patient's peripheral Mood mononuclear cells by antigen capture assay and by sequencing a polymerase chain reaction product amplified from the env gene. Intervention and outcome The patient was advised of the nature and prognosis of her illness. Oral corticosteroids were tried without benefit. Conclusions The prevalence of HTLV‐I infection is low in Australia although it may be endemic in some Aboriginal communities. Most infections are asymptomatic but the chronic neurological disease associated with HTLV‐I infection has now been shown to exist in this country. HTLV‐I infection should be considered in the aetiology of myelopathy without another obvious cause.