Summary
An autopsy case of human T lymphotropic virus I-associated myelopathy (HAM) of a duration of 28 years in a 61-year-old man with serological confirmation of HTLV-I infection was reported. The spinal cord was grossly atrophic. There was severe symmetrical degeneration of the lateral funiculi, particularly of the bilateral pyramidal tracts, involving all levels of the spinal cord, but anterior horn cells were relatively well preserved. In the most severely damaged middle and lower thoracic segments, the white matter degeneration also involved the anterior funiculi. In the degenerated white matter, both the myelin and axons were equally lost and had been replaced by glial scars. Marked adventitial fibrosis was commonly seen in small parenchymal vessls in both the white and gray matter. Although there was no evidence of inflammation in the spinal cord, mild lymphocytic infiltration was occasionally observed in the subarachnoid and perivascular spaces in the brain stem, cerebellum and cerebrum. This case was considered as a burnt-out case of HAM.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Akizuki S, Nakazato O, Higuchi Y, Tanabe K, Setoguchi M, Yoshida S, Miyazaki Y, Yamamoto S, Sudou S, Sannomiya K, Okajima T (1987) Necropsy findings in HTLV-I associated myelopathy. Lancet I:156–157
Beal MF, Richardson EP Jr (1981) Primary lateral sclerosis. A case report. Arch Neurol 38:630–633
Bhagavati S, Ehrlich G, Kula RW, Kwok S, Sninsky J, Udani V, Poiesz BJ (1988) Detection of human T cell lymphoma/leukemia virus type I DNA and antigen in spinal fluid and blood of patients with chronic progressive myelopathy. N Engl J Med 318:1141–1147
Cruickshank JK, Rudge P, Dalgleish AG, Newton M, McLean BN, Barnard RO, Kendall BE, Miller DH (1989) Tropical spastic paraparesis and human T cell lymphotropic virus type I in the United Kingdom. Brain 112:1057–1090
DeFreitas E, Wroblewska Z, Maul G, Sheremata W, Ferrante P, Lavi E, Harper M, DiMarzo-Veronese F, Koprowski H (1987) HTLV-I infection of cerebrospinal fluid T cells from patients with chronic neurologic disease. AIDS Res Hum Retroviruses. 3:19–32
Gessain A, Barin F, Vernant J-C, Gout O, Maurs L, Calendar A, de The G (1985) Antibodies to human T lymphotropic virus type I in patients with tropical spastic paraparesis. Lancet II:407–409
Hirose S, Uemura Y, Fujishita M, Kitagawa T, Yamashita M, Imamura J, Ohtsuki Y, Taguchi H, Miyoshi I (1986) Isolation of HTLV-I from cerebrospinal fluid of a patient with myelopathy. Lancet II:397–398
Iwasaki Y (1990) Pathology of chronic myelopathy associated with HTLV-I infection. J Neurol Sci 96:103–123
Izumo S, Usuku K, Osame M, Machigashira K, Johonoso M, Nakagawa M (1989) The neuropathology of HTLV-I-associated myelopathy in Japan: report of an autopsy case and review of the literature. In: Roman GC, Vernant J-C, Osame M (eds) HTLV-I and nervous system. Alan Liss, New York, pp 261–267
Jacobson S, Raine CS, Minogiolo ES, McFarlin DE (1988) Isolation of an HTLV-I-like retrovirus from patients with tropical spastic paraparesis. Nature 331:540–543
Kobayashi I, Ota K, Yamamoto K, Murakami H, Maruyama S (1989) An autopsy case of HTLV-I associated myelopathy. Neurol Med Chir (Tokyo) 30:409–412
Mani KS, Mani AJ, Montgomery RD (1969) A spastic paraplegic syndrome in South India. J Neurol Sci 9:179–199
McKhann G II, Gibbs CJ Jr, Mora C, Rodgers-Johnson P, Zaninovic V (1988) Isolation and characterization of HTLV-I from symptomatic family members with tropical spastic paraparesis (HTLV-I encephalomyeloneuropathy). Neurology 38 [Suppl 1]: 166
Montgomery RD, Cruickshank EK, Robertson WB, McMenemey WH (1964) Clinical and pathological observation on Jamaican neuropathy. Brain 87:425–462
Moore GRW, Traugott U, Scheinberg, Raine CS (1989) Tropical spastic paraparesis: a model of virus-induced, cytotoxic T cell-mediated demyelination? Ann Neurol 26:523–530
Nakamura T, Tsujihata M, Shirabe S, Matsuo H, Ueki Y, Nagataki S (1989) Characterization of HTLV-I in a T-cell line established from a patient with myelopathy. Arch Neurol 46:35–37
Osame M, Matsumoto M, Usuku K, Izumo S, Ijichi N, Amitani H, Tara M, Igata A (1987) Chronic progressive myelopathy associated with elevated antibodies to human T lymphotropic virus type I and adult T cell leukemia like cells. Ann Neurol 21:117–122
Roman GC (1989) Tropical spastic paraparesis and HTLV-I myelitis. Handb Clin Neurol 12:525–542
Roman GC, Osame M (1988) Identity of HTLV-I-associated tropical spastic paraparesis and HTLV-I-associated myelopathy. Lancet I:651
Suzuki H, Franz H, Yamamoto T, Iwasaki Y, Konno H (1988) Identification of the normal microglial population in human and rodent nervous tissue using lectin-histochemistry. Neuropathol Appl Neurobiol 14:221–227
Ungar-Sargon JY, Lovelace RE, Brust JCM (1980) Spastic paraplegia-paraparesis A reappraisal. J Neurol Sci 46:1–12
WHO Report (1989) WHO Wkly Epidem Rec 49:382–383
Yoshida M, Osame M, Kawai M, Toita M, Kuwasaki N, Nishida Y, Hiraki Y, Takahashi K, Nomura K, Sonoda S, Eiraku N, Ijichi S, Usuku K (1989) Increased replication of HTLV-I in HTLV-I-associated myelopathy patients. Ann Neurol 26:331–335
Younger DS, Chou S, Hays AP, Lange DJ, Emerson R, Brin M, Thompson H, Rowland LP (1988) Primary lateral sclerosis. A clinical diagnosis reemerges. Arch Neurol 45:1304–1307
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sasaki, S., Komori, T., Maruyama, S. et al. An autopsy case of human T lymphotropic virus type I-associated myelopathy (HAM) with a duration of 28 years. Acta Neuropathol 81, 219–222 (1990). https://doi.org/10.1007/BF00334512
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00334512