HTLV-Iと関連したニューロパチーが考えられた1例

HTLV-I-associated Neuropathy

　HTLV-Iとの関連が考えられた緩徐進行性のニューロパチーで，錐体路徴候を欠いた70歳男性例を報告した。神経生検で軸索変性と脱髄を示していた。筋生検では神経原性変化にヘルパーT細胞主体の細胞浸潤を認めた。血清と髄液でのATL様細胞の存在と末梢血のリンパ球のポリクローナルなHTLV-Iプロウイルスの組み込みなどからHTLV-Iの感染状態はHAMで認められるものであったが，臨床的にはHAMとは診断できなかった。

A 70-year-old man was admitted to our hospital because of a 15-year history of walking difficulty, disturbance of sensation in the palm for 2 years and hand tremor for 6 months. On admission, the scapulohumeral muscles showed fasciculation and atrotphy. There was action tremor in the upper limb, and the proximal lower limb showed atrophy and weakness. Standing and walking were impos-sible. Deep tendon reflexes were decreased in lower limbs. Pathologic reflexes were not found. There was distal dominant sensory disturbance, and urina-tion was difficult.