Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Improvement of human T-lymphotropic virus type 1 associated demyelinating neuropathy with corticosteroid therapy

Masayoshi Yamamoto, M.D.1)2), Yoko Shibata, M.D.1)3), Nobuyuki Oka, M.D., Ph.D.4), Manabu Inoue, M.D., Ph.D.1)5), Naoko Tachibana, M.D., Ph.D.1) and Toshiaki Hamano, M.D., Ph.D.1)

1)Department of Neurology, Kansai Electric Power Hospital
2)Department of Neurology, Kitano Hospital, Tazuke Kofukai Medical Research Institute
3)Department of Neurology, Osaka Red Cross Hospital
4)Department of Neurology, National Hospital Organization Minami-Kyoto Hospital
5)Department of Neurology, Osaka City General Hospital

The patient was a 58-year-old man, who was hospitalized with progressive bilateral leg weakness, and sensory impairment in all four extremities. Chronic inflammatory demyelinating polyneuropathy (CIDP) was suspected based on an electrophysiological examination, and intravenous immunoglobulin therapy (IVIg) was initiated. However, his symptoms progressed. The serum and cerebrospinal fluid were positive for human T-lymphotropic virus type 1 (HTLV-1) antibodies; hence the patient was diagnosed as having HTLV-1 associated neuropathy. After administration of corticosteroid, muscle strength markedly improved. Thus, our findings suggest that rather than IVIg, corticosteroid therapy is recommended for the treatment of CIDP like neuropathy in HTLV-1 infected patients.
Full Text of this Article in Japanese PDF (599K)

(CLINICA NEUROL, 58: 166|170, 2018)
key words: HTLV-1 associated neuropathy, CIDP, soluble interleukin 2-receptor, steroid, intravenous immunoglobulin

(Received: 28-Aug-17)