Abstract
Human T-lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a slowly progressive, inflammatory disease of the central nervous system (CNS). We report a patient with transverse myelitis, who exhibited acute onset and rapid progression of the disease and whose symptoms resembled those observed in multiple sclerosis with spinal cord presentation. During neurological exacerbation of the condition, the HTLV-I proviral load in the cerebrospinal fluid (CSF) increased to 10 times that in the peripheral blood. This suggests that the accumulation of HTLV-I-infected cells in the CNS contributes to neurological exacerbation. Based on the increased proviral load in the CSF, we diagnosed the disease as acute progressive HAM/TSP. The measurement of the HTLV-I proviral load in the CSF is useful for the diagnosis of HAM/TSP and for monitoring its progression.
Acknowledgements
The authors thank the staff of the Department of Neurology and Geriatrics, Kagoshima University, for providing clinical care to the patient. The authors are also grateful to Dr. Moe Moe Aye for critically reviewing the manuscript. This study was supported by the Grant-in-Aid for Research on Brain Science, provided by the Ministry of Health, Labour, and Welfare, Japan. No financial or other potential conflicts of interest exist. This study was approved by the Ethics Committee of Kagoshima University. Written informed consent was obtained from the patient prior to the study, in accordance with the institutional guidelines. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.