CASE REPORT
Sarcoidosis and HTLV-1 infection
1 Department of Neurology, Greater Manchester Centre for Clinical Neurosciences, Salford M6 8HD, UK
2 Department of Immunology, Hope Hospital, Stott Lane, Salford M6 8HD, UK
Correspondence to:
Correspondence to:
Dr D H McKee
Department of Neurology, Greater Manchester Centre for Clinical Neurosciences, Hope Hospital, Stott Lane, Salford M6 8HD, UK; david{at}mckee490.freeserve.co.uk
An asymptomatic, homosexual, white man was found to have an abnormal chest x ray. A presumptive diagnosis of sarcoidosis was made, but pulmonary function tests and a transbronchial biopsy were normal. He then remained asymptomatic for 10 years until he developed a progressive spastic paraparesis. At this point, antibodies to human T cell lymphotropic virus type 1 (HTLV-1) were identified in the serum and cerebrospinal fluid, and the diagnosis of HTLV-1 associated myelopathy was made, the history suggesting sexual exposure to HTLV-1 many years previously. HTLV-1 is associated with a spectrum of immune related disorders, including a pulmonary sarcoid-like syndrome. Infection with this chronic proinflammatory retrovirus should be considered in the differential diagnosis of all immune disorders in at risk individuals.
Abbreviations: ACE, angiotensin converting enzyme; CSF, cerebrospinal fluid; HAM, human T cell lymphotropic virus type 1 associated myelopathy; HIV, human immunodeficiency virus; HTLV-1, human T cell lymphotropic virus type 1; TSP, tropical spastic paraparesis
Keywords: sarcoidosis; human T cell lymphotropic virus type 1
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