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

eNeurologicalSci. 2023 Feb 20:31:100453. doi: 10.1016/j.ensci.2023.100453. eCollection 2023 Jun.

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.

Keywords: 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.

Publication types

  • Case Reports