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Amyotrophic lateral sclerosis presentation of a human T‐lymphotropic virus type‐1 myelopathy – insight into pathogenesis

A 41‐year‐old human T‐lymphotropic virus type 1‐positive woman developed a syndrome with upper and lower motor neuron signs sometime after bilateral vertebral artery dissections. Over 2 years, she developed a progressive myelopathy affecting predominantly the motor system. She had the picture of a ‘...

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Bibliographic Details
Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2015-09, Vol.123 (9), p.815-820
Main Authors: Alkhawajah, Nuha M., Chapman, Kristine M., Moore, G. R. Wayne, Oger, Joel
Format: Article
Language:English
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Summary:A 41‐year‐old human T‐lymphotropic virus type 1‐positive woman developed a syndrome with upper and lower motor neuron signs sometime after bilateral vertebral artery dissections. Over 2 years, she developed a progressive myelopathy affecting predominantly the motor system. She had the picture of a ‘person in a barrel’ and died from complications. At autopsy, spinal cord revealed inflammatory infiltrates and extensive gliosis involving mainly the anterior horns. The vertebral arterial dissections may have permitted the entry of infected lymphocytes and macrophages, secreting cytokines and metalloproteinases, into the medulla progressing to the spinal cord. Few cases with pathological correlation have been reported.
ISSN:0903-4641
1600-0463
DOI:10.1111/apm.12422