Ando Rina, Nishikawa Noriko, Tsujii Tomoaki, Iwaki Hirotaka, Yabe Hayato, Nagai Masahiro, Nomoto Masahiro
Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, Japan.
Intern Med. 2015;54(9):1105-7. doi: 10.2169/internalmedicine.54.3660. Epub 2015 May 1.
We herein report a case of Human T-lymphotropic virus type-I (HTLV-I)-associated myelopathy with bulbar palsy-type amyotrophic lateral sclerosis-like symptoms. A 52-year-old woman developed dyslalia at approximately 40 years of age, which slowly progressed. She presented with muscular atrophy and increased tendon reflexes of the extremities as well as bulbar palsy, from which motor neuron disease was suspected. Cerebrospinal fluid (CSF) testing revealed no abnormalities except for an elevated neopterin concentration at 143.17 pmol/mL (normal ≤30 pmol/mL). Her serum and CSF anti-HTLV-I antibody titers were also high. Intravenous infusions of methylprednisolone decreased the CSF neopterin concentration to 50.33 pmol/mL. Subsequent oral prednisolone therapy was effective in alleviating the symptoms.
我们在此报告一例与I型人类嗜T淋巴细胞病毒（HTLV-I）相关的脊髓病，伴有球麻痹型肌萎缩侧索硬化样症状。一名52岁女性在约40岁时出现构音障碍，并缓慢进展。她表现为肢体肌肉萎缩、腱反射亢进以及球麻痹，怀疑患有运动神经元病。脑脊液（CSF）检测除新蝶呤浓度升高至143.17 pmol/mL（正常≤30 pmol/mL）外无异常。她的血清和脑脊液抗HTLV-I抗体滴度也很高。静脉输注甲泼尼龙使脑脊液新蝶呤浓度降至50.33 pmol/mL。随后的口服泼尼松龙治疗有效缓解了症状。
