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A Clinicopathologic Study

Naoki Kasahata, MD; Junichi Shiota, MD, PhD; Yumi Miyazawa, MD; Imaharu Nakano, MD, PhD; Shigeo Murayama, MD, PhD

Arch Neurol. 2003;60:873-876.

Background  Recently, acute human T-lymphotropic virus type 1–associated myelopathy (HAM) was reported clinically without pathologic information. We report an autopsy case of acute HAM.

Objective  To report the case of a 52-year-old man with acute-onset gait disturbance followed by rapidly progressive paraplegia, who died 9 months later.

Results  The postmortem study showed swelling of the thoracic spinal cord. Histologically, there was inflammation and vacuolation in the white matter.

Conclusion  We propose that these pathologic findings, mimicking tropical spastic paraparesis, may represent the characteristic pathologic features of acute HAM.

From the Department of Neurology, Center for Cerebrovascular Disorders, Ushioda General Hospital, Yokohama (Drs Kasahata, Shiota, and Miyazawa); Department of Neurology, Jichi Medical School, Tochigi (Dr Nakano); and the Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo (Dr Murayama), Japan.