Pathological and virological assessment of acute HTLV-I-associated myelopathy complicated with encephalopathy and systemic inflammation

摘要: HTLV-I-associated myelopathy, also known as tropical spastic paraparesis (HAM/TSP), is a chronic inflammatory disease of the spinal cord. Acute cases are uncommon. We report case 41-year-old woman with acute HAM/TSP complicated encephalitis, an intense reaction nervous system and lymphocytic infiltration skeletal muscles, liver, salivary, adrenal pituitary glands. The immunohistochemical studies lymphocytes surrounding blood vessels showed both B- T-lymphocytes, in similar proportion, CD4- CD8-positive cells. In addition, many perivascular scattered macrophages were observed. Adult T-cell leukemia/lymphoma (ATL) was ruled out. marrow aspirate normal. Serial cerebrospinal fluid (CSF) analysis presence HTLV-I antibodies, but without intrathecal synthesis specific antibodies. Determination viral loads demonstrated increased levels CSF relative to peripheral may be associated widespread inflammation. pathological immunological findings help understand role immune-reactive cells pathogenesis myelopathy.