Widespread active inflammatory lesions in a case of HTLV-I-associated myelopathy lasting 29 years

Acta Neuropathologica
Yasushi IwasakiGen Sobue

Abstract

An autopsy case of human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM) of 29 years' duration is reported. The patient had no history of surgery or blood transfusion and likely contracted HTLV-I sexually while traveling in an endemic area. At age 45, the patient began to experience gait disturbance; he later developed spastic tetraparesis. Autopsy revealed marked gross spinal cord atrophy, particularly in the middle to lower thoracic levels. Myelin and axonal degeneration were identified predominantly in the middle to lower thoracic spinal cord, extending into the medulla oblongata and lumbar cord. Inflammatory infiltrates of mononuclear cells were diffuse in the white and gray matter of the spinal cord and medulla oblongata, particularly in perivascular areas. These infiltrates were also observed in perivascular areas of the pons, midbrain, cerebellum, and cerebrum. More than half of the infiltrating cells were positive for the pan-T cell marker UCHL-1, but some were positive for the B cell marker SL-26. There were far more CD8-positive cells than CD4-positive cells in the spinal parenchyma and perivascular areas. Neurons in the anterior horn, Clarke's column, and intermediolateral column were relatively well...Continue Reading

References

Jun 1, 1992·Acta Paediatrica Japonica; Overseas Edition·S IzumoM Osame
Apr 1, 1990·Journal of the Neurological Sciences·Y Iwasaki
May 3, 1986·Lancet·M OsameM Tara
Jan 17, 1987·Lancet·S AkizukiK Sannomiya
Jul 1, 1993·Journal of Neuropathology and Experimental Neurology·F UmeharaM Osame
Jul 17, 1998·Annals of Neurology·M C LevinS Jacobson
Oct 19, 2000·Neuropathology : Official Journal of the Japanese Society of Neuropathology·S IzumoM Osame

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Citations

May 4, 2010·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Eiji MatsuuraSteven Jacobson
Jan 24, 2007·Lancet Neurology·Gustavo C Román, Lydia I Navarro-Román
Jun 26, 2009·Autonomic Neuroscience : Basic & Clinical·Nagato KuriyamaMasanori Nakagawa
Jan 14, 2010·Arquivos de neuro-psiquiatria·Fidias E Leon-SarmientoNash N Boutros
Apr 19, 2012·Arquivos de neuro-psiquiatria·Marzia Puccioni-SohlerCaterina Mainero

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