Hori T, Tsuboi Y, Kiyose H, Kamei H, Nishimaru K, Yamada T
Department of Internal Medicine and Health Care, School of Medicine, Fukuoka University, Japan.
Rinsho Shinkeigaku. 1998 Jul;38(7):645-8.
A 45-year-old female was admitted to our hospital complaining of abnormal sensation in the upper and lower extremities. She was given a diagnosis of smouldering type adult T cell leukemia 9 months before admission. On admission, neurological examination revealed sensory disturbance of polyneuropathy type, and generalized hyporeflexia. Nerve conduction study demonstrated decreased F wave appearance rate. Motor unit potentials in electromyelography had long duration and high amplitude. MR imaging of the brain showed multiple abnormal lesions in the periventricular and subcortical white matter. CSF protein was mildly increased, and anti-HTLV-I antibody was positive. Treatment with corticosteroid was effective, resulting in disappearance of sensory symptoms and normalization of F wave appearance. The present case is different from HAM, and the above clinical features may fit to the disease entity of HTLV-I associated polyradiculoneuropathy and cerebral white matter lesions.
一名45岁女性因四肢感觉异常入院。入院前9个月被诊断为冒烟型成人T细胞白血病。入院时，神经学检查显示为多神经病型感觉障碍和全身性反射减退。神经传导研究显示F波出现率降低。肌电图中的运动单位电位持续时间长且波幅高。脑部磁共振成像显示脑室周围和皮质下白质有多个异常病变。脑脊液蛋白轻度升高，抗HTLV-I抗体呈阳性。皮质类固醇治疗有效，感觉症状消失，F波出现恢复正常。本病例与HAM不同，上述临床特征可能符合HTLV-I相关多神经根神经病和脑白质病变的疾病实体。
