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Abnormalities of spinal magnetic resonance images implicate clinical variability in human T-cell lymphotropic virus type I-associated myelopathy

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Abstract

This study investigated the role of human T-cell lymphotropic virus type I HTLV-I infection in 11 patients who developed slowly progressive myelopathy with abnormal spinal cord lesions. The authors performed clinical and neuroradiological examinations and calculated the odds that an HTLV-I-infected individual of a specific genotype, age, and provirus load has HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Anti-HTLV-I antibodies were present in both the serum and cerebrospinal fluid in all of the patients. Abnormal magnetic resonance imaging (MRI) lesions were classified as cervical to thoracic type (CT type), cervical type (C type), and thoracic type (T type). In each type, there was swelling of the spinal cords with high-intensity lesions, which were located mainly in bilateral posterior columns, posterior horns, or lateral columns. Virological and immunological analyses revealed that all patients showed a high risk of developing HAM/TSP. These 11 patients may have developed HAM/TSP, as manifested by spinal cord abnormalities shown on MRI. These MRIs implicate clinical variability of HAM/TSP, which may indicate active-early stages of HAM/TSP lesions.

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References

  • Aye MM, Matsuoka E, Moritoyo T, Umehara F, Suehara M, Hokezu Y, Yamanaka H, Isashiki Y, Osame M, Izumo S (2000). Histopathological analysis of four autopsy cases of HTLV-I-associated myelopathy/tropical spastic paraparesis: inflammatory changes occur simultaneously in the entire central nervous system. Acta Neuropathol (Berl) 100: 245–252.

    Article  CAS  Google Scholar 

  • Furukawa Y, Yamashita M, Usuku K, Izumo S, Nakagawa M, Osame M (2000). Phylogenetic subgroups of human T cell lymphotropic virus (HTLV) type I in the tax gene and their association with different risks for HTLV-I-associated myelopathy/tropical spastic paraparesis. J Infect Dis 182: 1343–1349.

    Article  CAS  PubMed  Google Scholar 

  • Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A, de The G (1985). Antibodies to human T-lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet 2: 407–410.

    Article  CAS  PubMed  Google Scholar 

  • Iwasaki Y (1990). Pathology of chronic myelopathy associ-ated with HTLV-I infection (HAM/TSP). J Neurol Sci 96: 103–123.

    Article  CAS  PubMed  Google Scholar 

  • Iwasaki Y, Ohara Y, Kobayashi I, Akizuki S (1992). Infiltration of helper/inducer T lymphocytes heralds central nervous system damage in human T-cell leukemia virus infection. Am J Pathol 140: 1003–1008.

    CAS  PubMed  Google Scholar 

  • Jeffery KJ, Siddiqui AA, Bunce M, Lloyd AL, Vine AM, Witkover AD, Izumo S, Usuku K, Welsh KI, Osame M, Bangham CR (2000). The influence of HLA class I alleles and heterozygosity on the outcome of human T cell lymphotropic virus type I infection. J Immunol 165: 7278–7284.

    CAS  PubMed  Google Scholar 

  • Jeffery KJ, Usuku K, Hall SE, Matsumoto W, Taylor GP, Procter J, Bunce M, Ogg GS, Welsh KI, Weber JN, Lloyd AL, Nowak MA, Nagai M, Kodama D, Izumo S, Osame M, Bangham CR (1999). HLA alleles determine human T-lymphotropic virus-I (HTLV-I) proviral load and the risk of HTLV-I-associated myelopathy. Proc Natl Acad Sci U S A 96: 3848–3853.

    Article  CAS  PubMed  Google Scholar 

  • Levin MC, Lehky TJ, Flerlage AN, Katz D, Kingma DW, Jaffe ES, Heiss JD, Patronas N, McFarland HF, Jacobson S (1997). Immunologic analysis of a spinal cord-biopsy specimen from a patient with human T-cell lymphotropic virus type I-associated neurologic disease. New Engl J Med 336: 839–844.

    Article  CAS  PubMed  Google Scholar 

  • Nagai M, Usuku K, Matsumoto W, Kodama D, Takenouchi N, Moritoyo T, Hashiguchi S, Ichinose M, Bangham CR, Izumo S, Osame M (1998). Analysis of HTLV-I proviral load in 202 HAM/TSP patients and 243 asymptomatic HTLV-I carriers: high proviral load strongly predisposes to HAM/TSP. J NeuroVirol 4: 586–593.

    Article  CAS  PubMed  Google Scholar 

  • Nose H, Saito M, Usuku K, Sabouri AH, Matsuzaki T, Kubota R, Eiraku N, Furukawa Y, Izumo S, Arimura K, Osame M (2006). Clinical symptoms and the odds of human T-cell lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in healthy virus carriers: application of best-fit logistic regression equation based on host genotype, age and provirus load. J NeuroVirol 12: 171–177.

    Article  CAS  PubMed  Google Scholar 

  • Osame M (1990). Review of WHO Kagoshima meeting and diagnostic guidelines for HAM/TSP. In: Human Retrovirology: HTLV. Blattner WA (ed). New York: Raven Press, pp 191–197.

    Google Scholar 

  • Osame M, Usuku K, Izumo S, Ijichi N, Amitani H, Igata A, Matsumoto M, Tara M (1986). HTLV-I associated myelopathy, a new clinical entity. Lancet 1: 1031–1032.

    Article  CAS  PubMed  Google Scholar 

  • Umehara F, Osame M (2003). Histological analysis of HAM/TSP pathogenesis. In: Two decades of adult T-cell leukemia and HTLV-I research. Sugamura K, Uchiyama T, Masao M, Kannagi M (eds). Tokyo: Japan Scientific Societies Press, pp 141–148.

    Google Scholar 

  • Shakudo M, Inoue Y, Tukada T (1999). HTLV-I-associated myelopathy: acute progression and atypical MR findings. Am J Neuroradiol 20: 1417–1421.

    CAS  PubMed  Google Scholar 

  • Tajima Y, Kishimoto R, Sudoh K, Miyazaki Y, Kikuchi S, Tashiro K (2003). Spinal magnetic resonance image alterations in human T-lymphotropic virus type I-associated myelopathy patients before and after immunomodulating treatment. J Neurol 250: 750–753.

    Article  PubMed  Google Scholar 

  • Umehara F, Izumo S, Nakagawa M, Ronquillo AT, Takahashi K, Matsumuro K, Sato E, Osame M (1993). Immunocytochemical analysis of the cellular infiltrate in the spinal cord lesions in HTLV-I associated myelopathy. J Neuropathol Exp Neurol 52: 424–430.

    Article  CAS  PubMed  Google Scholar 

  • Umehara F, Nagatomo S, Yoshishige K, Saito M, Furukawa Y, Usuku K, Osame M (2004). Chronic progressive cervical myelopathy with HTLV-I infection: variant form of HAM/TSP? Neurology 63: 1276–1280.

    CAS  PubMed  Google Scholar 

  • Umehara F, Tokunaga N, Hokezu Y, Hokonohara E, Yoshishige K, Shiraishi T, Okubo R, Osame M (2006). Relapsing cervical cord lesions on MRI in patients with HTLV-I-associated myelopathy. Neurology 66: 289.

    Article  CAS  PubMed  Google Scholar 

  • Vine AM, Witkover AD, Lloyd AL, Jeffery KJ, Siddiqui A, Marshall SE, Bunce M, Eiraku N, Izumo S, Usuku K, Osame M, Bangham CR (2002). Polygenic control of human T lymphotropic virus type I (HTLV-I) provirus load and the risk of HTLV-I-associated myelopathy/tropical spastic paraparesis. J Infect Dis 186: 932–939.

    Article  CAS  PubMed  Google Scholar 

  • Watanabe M, Yamashita T, Hara A, Murakami T, Ando Y, Uyama E, Mita S, Uchino M (2001). High signal intensity in the spinal cord on T2-weighted images in rapidly progressive tropical spastic paresis. Neuroradiology 43: 231–233.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka 8-35-1, 890-8520, Kagoshima, Japan

    Fujio Umehara, Hirohisa Nose, Kimiyoshi Arimura & Mitsuhiro Osame

  2. Department of Microbiology, Kanazawa Medical University, Ishikawa, Japan

    Mineki Saito

  3. Department of Neurology, Kitazato University School of Medicine, Sagamihara, Japan

    Michinari Fukuda & Mieko Ogino

  4. Department of Neurology, University of Occupational and Environmental Health, Kitakyusyu, Japan

    Tomoko Toyota & Tomoaki Yuhi

Authors
  1. Fujio Umehara
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  2. Hirohisa Nose
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  3. Mineki Saito
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  4. Michinari Fukuda
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  5. Mieko Ogino
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  6. Tomoko Toyota
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  7. Tomoaki Yuhi
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  8. Kimiyoshi Arimura
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  9. Mitsuhiro Osame
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Correspondence to Fujio Umehara.

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Umehara, F., Nose, H., Saito, M. et al. Abnormalities of spinal magnetic resonance images implicate clinical variability in human T-cell lymphotropic virus type I-associated myelopathy. Journal of NeuroVirology 13, 260–267 (2007). https://doi.org/10.1080/13550280701258431

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  • DOI: https://doi.org/10.1080/13550280701258431

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