Immunologic Analysis of a Spinal Cord–Biopsy Specimen from a Patient with Human T-Cell Lymphotropic Virus Type I–Associated Neurologic Disease

Abstract

Human T-cell lymphotropic virus type I (HTLV-I) is associated with adult T-cell leukemia and a chronic progressive neurologic disease, HTLV-I–associated myelopathy–tropical spastic paraparesis (hereafter referred to as HTLV-I–associated myelopathy).1–5 HTVL-I is endemic in Japan, the Caribbean, Africa, and South America.5 Risk factors for infection include sexual contact, exchange of blood products, and vertical transmission from mother to child.5 HTLV-I–associated myelopathy causes progressive myelopathy with atrophy of the spinal cord.5,6 Subcortical white-matter lesions are sometimes present on magnetic resonance imaging.5–7 Cerebrospinal fluid shows pleocytosis, elevated titers of IgG, and oligoclonal bands.8–10 Autopsy results correlate with neurologic findings . . .