HTLV-1-associated demyelinating neuropathy: A case report and review of the literature.

HTLV - 1 相关脱髓鞘性神经病 ： 1 例报告和文献复习。

• 发表时间: Jun 2023
• 来源期刊: eNeurologicalSci
• DOI: 10.1016/j.ensci.2023.100453
• PMID: 36891478
• 文章类型: Case Reports
• 作者列表: Tamaki K,Mishima T,Tateishi Y,Mera H,Ogura H,Tsugawa J,Fujioka S,Takamatsu Y,Tsuboi Y

关键词: ATL, adult T-cell leukemia/lymphoma; Adult T-cell leukemia/lymphoma; CIDP, chronic inflammatory demyelinating polyneuropathy; CSF, cerebrospinal fluid; CXCL10, C-X-C motif chemokine 10; Corticosteroid; HAM/TSP, HTLV-1-associated myelopathy/tropical spastic paraparesis; HTLV-1; HTLV-1, human T-cell leukemia virus type 1; HTLV-1-associated demyelinating neuropathy; IVIg, intravenous immunoglobulin; Intravenous immunoglobulin therapy; mPSL, methylprednisolone

Abstract

A 78-year-old man developed paresthesias in the extremities. He was referred to our hospital because of positive anti-human T-cell leukemia virus type 1 (HTLV-1) antibodies in the serum and the presence of abnormal lymphocytes. He was diagnosed as chronic-type adult T-cell leukemia/lymphoma. Neurological examination revealed sensory impairment in the distal parts of the extremities with loss of deep tendon reflexes. Nerve conduction study showed motor and sensory demyelinating polyneuropathy, indicating a diagnosis of HTLV-1-associated demyelinating neuropathy. Corticosteroid therapy followed by intravenous immunoglobulin therapy improved his symptoms. Since demyelinating neuropathy associated with HTLV-1 infection is not well recognized, we here report its characteristics and clinical course through our case report and literature review.

摘要

一名78岁的男子四肢出现感觉异常。由于血清中的抗人T细胞白血病病毒1型（HTLV-1）抗体阳性和淋巴细胞异常，他被转诊到我院。他被诊断为慢性型成人T细胞白血病/淋巴瘤。神经系统检查显示四肢远端感觉障碍，并伴有深层肌腱反射丧失。神经传导研究显示运动和感觉脱髓鞘性多发性神经病，提示HTLV-1相关脱髓鞘性神经病的诊断。皮质类固醇治疗后静脉注射免疫球蛋白治疗改善了他的症状。由于与HTLV-1感染相关的脱髓鞘性神经病没有得到很好的认识，我们在这里通过我们的病例报告和文献回顾报告其特点和临床过程。