PDF(Pubmed)
Abstract：
Human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with adult T-cell lymphoma (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In addition to HAM/TSP and ATL, HTLV-I-associated encephalopathy and cerebellar involvement have been reported. We report a case of an 87-year-old Japanese woman presenting with progressive dysarthria and gait disturbance. Neurological examination showed word-finding difficulty, scanning speech, saccadic eye movements, ocular dysmetria, gaze-evoked nystagmus and bilateral dysmetria. There was no motor weakness or spasticity. HTLV-I antibody was detected in both her serum and cerebrospinal fluid. Cerebrospinal fluid neopterin (57 pg/mL) and IgG index (3.27) were significantly elevated. MRI showed cerebellar swelling. She was finally diagnosed with HTLV-I associated cerebellitis. Two courses of high-dose intravenous methylpredonine therapy attenuated cerebellar ataxia and cerebellar swelling. It suggests that cerebellitis can result from HTLV-I infection, regardless of the existence of ATL or HAM/TSP.
摘要：
人类嗜T淋巴细胞病毒I型（HTLV-I）是与成人T细胞淋巴瘤（ATL）和HTLV-I相关的脊髓病/热带痉挛性轻瘫（HAM/TSP）相关的逆转录病毒。除了HAM/TSP和ATL，已经报道了HTLV-I相关的脑病和小脑受累。我们报告了一例87岁的日本妇女，患有进行性构音障碍和步态障碍。神经系统检查显示单词查找困难，扫描语音,扫视眼球运动，视力障碍,凝视诱发的眼球震颤和双侧异常。没有运动无力或痉挛。在她的血清和脑脊液中均检测到HTLV-I抗体。脑脊液新蝶呤（57pg/mL）和IgG指数（3.27）显着升高。MRI显示小脑肿胀。她最终被诊断为HTLV-I相关的小脑炎。两个疗程的大剂量静脉注射甲基泼尼松治疗可减轻小脑共济失调和小脑肿胀。提示HTLV-I感染可导致小骨炎,无论是否存在ATL或HAM/TSP。
