Human T-lymphotropic virus type I-associated myelopathy in patients with the acquired immunodeficiency syndrome.

Abstract

We describe two cases of serologically confirmed human T-lymphotropic virus type I (HTLV-I)-associated myelopathy involving North American men coinfected by the human immunodeficiency virus type 1. Our first patient suffered from a gradually progressive spastic paraparesis for 10 years prior to presenting with Kaposi's sarcoma, while our second patient developed subacutely progressive spastic paraparesis in the setting of full-blown acquired immunodeficiency syndrome. Autopsy examination of the spinal cords from these two cases revealed widespread axonal loss and demyelination principally involving the lateral columns of case no. 1 and the lateral and anterior columns of case no. 2. Vascular sclerosis and hyalinization were prominent in both cases, but in neither was there a conspicuous inflammatory component. In case no. 2, HTLV-I mRNA was not detected by in situ hybridization, but HTLV-I proviral DNA sequences were detected in this case by polymerase chain reaction. Neither case exhibited multinucleated cell (human immunodeficiency virus type 1) myelitis, vacuolar myelopathy, or evidence of HTLV-II infection by polymerase chain reaction assay.

Cite this paper

@article{Rosenblum1992HumanTV, title={Human T-lymphotropic virus type I-associated myelopathy in patients with the acquired immunodeficiency syndrome.}, author={Marc K. Rosenblum and Bruce J. Brew and Barbara M. Hahn and George M. Shaw and A. T. Haase and Stacene R Maroushek and Richard W. Price}, journal={Human pathology}, year={1992}, volume={23 5}, pages={513-9} }