Smadja D, Bellance R, Cabre P, Arfi S, Vernant J C
Department of Neurology, University Hospital of Fort-de-France, Martinique, French West Indies.
Acta Neurol Scand. 1995 Sep;92(3):206-12. doi: 10.1111/j.1600-0404.1995.tb01689.x.
Myositis linked to HTLV-1 is unfrequent. Over a period of 8 years, 14 patients with inflammatory myopathy were diagnosed in Martinique. Seven were seropositive for HTLV 1 antibody; the clinical and pathological data of whom are presented herein. Five patients presented with polymyositis, two with dermatomyositis. All seven patients had extra-muscular clinical features including neuropathy (4/7) and myelopathy (6/7), resulting in a quite peculiar clinical picture. Muscle biopsy showed a neurogenic process combined with myositic changes in 3/7 patients. Corticotherapy led to dramatic improvement in only one case, but with no sustained effect. HTLV 1 may be considered the etiological agent of this form of dermato-polymyositis, characterized by a clearly distinctive clinico-pathological picture, and a poor response to corticotherapy. As in the case of tropical spastic paraparesis/HTLV 1 associated myelopathy, careful assessment of non-steroidal therapy is now warranted.
与人类嗜T淋巴细胞病毒1型(HTLV-1)相关的肌炎并不常见。在8年的时间里,马提尼克岛确诊了14例炎性肌病患者。其中7例HTLV-1抗体血清学呈阳性;本文展示了他们的临床和病理数据。5例患者表现为多发性肌炎,2例为皮肌炎。所有7例患者都有肌肉外临床特征,包括神经病变(4/7)和脊髓病(6/7),形成了一种非常特殊的临床症状。肌肉活检显示,7例患者中有3例存在神经源性病变并伴有肌炎改变。皮质类固醇疗法仅在1例患者中带来显著改善,但无持续效果。HTLV-1可被视为这种形式的皮肤多发性肌炎的病原体,其特征为明显独特的临床病理表现,以及对皮质类固醇疗法反应不佳。与热带痉挛性截瘫/HTLV-1相关脊髓病的情况一样,现在有必要仔细评估非甾体疗法。