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CD8 and CD4 T cell-mediated polymyositis complicating the HTLV-1 associated myelopathy. Quantitative evaluation of corticosteroid treatment.

AbstractINTRODUCTION:
Inflammatory myopathy is a treatable cause of worsening in the spectrum of neurological conditions that may develop during the course of HTLV-1 infection.
MATERIAL AND METHODS:
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.
RESULTS:
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.
CONCLUSION:
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.
AuthorsA J Waclawik, R Fadic, B P Lotz, B R Beinlich, P J Lewandoski, M Sanjak, B R Brooks
JournalActa neurologica Scandinavica (Acta Neurol Scand) Vol. 94 Issue 2 Pg. 115-9 (Aug 1996) ISSN: 0001-6314 [Print] Denmark
PMID8891056 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents
  • CD4 Antigens
  • CD8 Antigens
  • Creatine Kinase
  • Prednisone
Topics
  • Anti-Inflammatory Agents (administration & dosage, therapeutic use)
  • Biopsy
  • CD4 Antigens (immunology)
  • CD8 Antigens (immunology)
  • Creatine Kinase (blood)
  • Fluorescent Antibody Technique
  • HTLV-I Infections (complications)
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal (chemistry)
  • Paraparesis, Tropical Spastic (complications, drug therapy)
  • Polymyositis (complications, drug therapy)
  • Prednisone (administration & dosage, therapeutic use)

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