Lehky T J, Flerlage N, Katz D, Houff S, Hall W H, Ishii K, Monken C, Dhib-Jalbut S, McFarland H F, Jacobson S
Neuroimmunology Branch, NINDS, NIH, Bethesda, MD 20892, USA.
Ann Neurol. 1996 Nov;40(5):714-23. doi: 10.1002/ana.410400507.
Human T-cell lymphotropic virus type II (HTLV-II) is endemic in several ethnic tribes and among intravenous drug users in metropolitan areas. Despite the presence of HTLV-II in these various populations, the association of HTLV-II with disease is sparse and mainly limited to isolated case reports. This study is an extension of an earlier description of an HTLV-II-infected patient with neurologic disease and presents the clinical and immunologic findings of 4 patients with HTLV-II seropositivity and spastic paraparesis. The patients are of African-American origin with 3 of the patients being of Amerindian descent. All of the patients are seronegative for the human immunodeficiency virus (HIV). The patients progressed to a nonambulatory state in less than 5 years. Magnetic resonance imaging studies obtained from 3 of the patients demonstrated white matter disease in the cerebrum and spinal cord. The cerebrospinal fluid and serum contained antibodies to HTLV-II. The presence of proviral HTLV-II was confirmed by polymerase chain reaction analysis of peripheral blood lymphocytes (PBLs). A spinal cord biopsy from 1 patient demonstrated HTLV RNA within a lesion. Immunologic studies on 2 patients demonstrated that spontaneous lymphoproliferation of PBLs was present but decreased relative to HTLV-I-infected patients. The clinical and immunologic findings from these HTLV-II-infected patient resemble those found in HTLV-I-associated myelopathy/tropical spastic paraparesis.
人类嗜T淋巴细胞病毒II型（HTLV-II）在几个种族部落以及大都市地区的静脉吸毒者中呈地方性流行。尽管在这些不同人群中存在HTLV-II，但HTLV-II与疾病的关联很少，主要限于个别病例报告。本研究是对一名患有神经系统疾病的HTLV-II感染患者早期描述的扩展，并展示了4例HTLV-II血清阳性和痉挛性截瘫患者的临床和免疫学发现。这些患者为非裔美国人，其中3例有美洲印第安人血统。所有患者的人类免疫缺陷病毒（HIV）血清学检测均为阴性。患者在不到5年的时间里发展到无法行走的状态。对其中3例患者进行的磁共振成像研究显示大脑和脊髓存在白质病变。脑脊液和血清中含有抗HTLV-II抗体。通过对外周血淋巴细胞（PBL）进行聚合酶链反应分析，证实了前病毒HTLV-II的存在。对1例患者进行的脊髓活检显示病变内存在HTLV RNA。对2例患者的免疫学研究表明，PBL存在自发淋巴细胞增殖，但相对于HTLV-I感染患者有所减少。这些HTLV-II感染患者的临床和免疫学发现与HTLV-I相关脊髓病/热带痉挛性截瘫患者的发现相似。
