Mizokami T, Okamura K, Sato K, Kuroda T, Itoyama Y, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka.
Intern Med. 1994 Nov;33(11):703-5. doi: 10.2169/internalmedicine.33.703.
A 28-year-old woman noticed a progressive gait disturbance after her first delivery. At the age of 32, the gait disturbance improved during her second pregnancy, but became worse after delivery and eventually resulted in a scissoring gait. At the age of 34, she became transiently thyrotoxic and was diagnosed as having painless thyroiditis and HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP). The findings of this case suggest that the postpartum exacerbation of HAM/TSP was probably due to a rebound phenomenon after immunosuppression during pregnancy, and that the immunological abnormalities associated with HAM/TSP might have played some role in the development of painless thyroiditis.
一名28岁女性在首次分娩后出现进行性步态障碍。32岁时，步态障碍在她第二次怀孕期间有所改善，但产后加重，最终导致剪刀步。34岁时，她出现短暂甲状腺毒症，被诊断为无痛性甲状腺炎和人类嗜T淋巴细胞病毒I型相关脊髓病/热带痉挛性截瘫（HAM/TSP）。该病例的研究结果表明，HAM/TSP产后加重可能是由于孕期免疫抑制后的反弹现象，并且与HAM/TSP相关的免疫异常可能在无痛性甲状腺炎的发生中起了一定作用。
