Waclawik A J, Fadic R, Lotz B P, Beinlich B R, Lewandoski P J, Sanjak M, Brooks B R
Neuromuscular Unit, University of Wisconsin Medical School, Madison 53792, USA.
Acta Neurol Scand. 1996 Aug;94(2):115-9. doi: 10.1111/j.1600-0404.1996.tb07040.x.
Inflammatory myopathy is a treatable cause of worsening in the spectrum of neurological conditions that may develop during the course of HTLV-1 infection.
To investigate the cause of subacute worsening in the strength of a 46-y-old black male with HTLV-1 associated myelopathy we performed electrodiagnostic examination and a muscle biopsy which was studied with histochemistry, immunocytochemistry and electron microscopy. Serial measurements of isometric muscle strength were performed during the course of corticosteroid treatment.
The muscle biopsy showed evidence of denervation atrophy and prominent inflammatory changes with autoaggressive features. Lymphocyte typing showed a predominance of CD8+ T cells. The patient had sustained, marked improvement in strength, especially of the upper extremities, with oral, high single-dose, alternate-day prednisone therapy.
A muscle biopsy should be considered in all patients with HTLV-1 associated weakness, especially when electromyography indicates possible coexisting primary muscle involvement and/or serum creatine kinase levels are elevated. HTLV-1-associated polymyositis can be successfully treated with corticosteroids.
炎性肌病是人类嗜T淋巴细胞病毒1型（HTLV-1）感染过程中可能出现的一系列神经系统疾病病情恶化的可治疗病因。
为探究一名46岁患有HTLV-1相关性脊髓病的黑人男性亚急性肌力下降的病因，我们进行了电诊断检查和肌肉活检，并采用组织化学、免疫细胞化学和电子显微镜对活检组织进行研究。在皮质类固醇治疗过程中，对等长肌力进行了系列测量。
肌肉活检显示有失神经萎缩的证据以及具有自身攻击性特征的显著炎症改变。淋巴细胞分型显示CD8+ T细胞占优势。口服高剂量单剂量隔日泼尼松治疗后，患者的肌力，尤其是上肢肌力持续显著改善。
所有HTLV-1相关性肌无力患者均应考虑进行肌肉活检，尤其是当肌电图显示可能并存原发性肌肉受累和/或血清肌酸激酶水平升高时。HTLV-1相关性多发性肌炎可用皮质类固醇成功治疗。
