Expansion of natural killer cells in peripheral blood in a Japanese elderly with human T-cell lymphotropic virus type 1-related skin lesions.

Shinsaku Imashuku,Kouichi Ohshima,Naoko Kudo,Kagekatsu Kubo

doi:10.1155/2014/937513

Shinsaku Imashuku, Kouichi Ohshima + Show 2 more

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https://doi.org/10.1155/2014/937513

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Abstract

Natural killer (NK) cells were proposed to play an important role in the pathogenesis of human T-cell lymphotropic virus type 1- (HTLV-1-) associated neurologic disease. Our patient was a 77-year-old Japanese man, who had been treated for infective dermatitis associated with HTLV-1 for nearly 10 years. When referred to us, he had facial eczema/edema as well as extensive dermatitis at the neck/upper chest and nuchal area/upper back regions. Dermal lesions had CD3+CD4+ cells, but no NK cells. Flow cytometry of his peripheral blood showed a phenotype of CD2+ (97%), CD3+ (17%), CD4+ (12%), CD7+ (94%), CD8+ (6%), CD11c+ (70%), CD16+ (82%), CD19+ (0%), CD20+ (0%), CD56+ (67%), HLA-DR+ (68%), and NKp46+ (36%). Absolute numbers of CD56+NK cells in the peripheral blood were in a range of 986/μL–1,270/μL. The expanded NK cells in the peripheral blood are considered to be reactive, to maintain the confinement of the HTLV-1-positive CD4+ cells in the skin, and to prevent the progression of the disease.

Highlights

Among human T-cell lymphotropic virus type 1 (HTLV-1) infected individuals, adult T-cell leukemia/lymphoma (ATLL), and a chronic neurological disease, the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) are two major symptomatic disorders
The infective dermatitis associated with HTLV-1 (IDH) is a chronic recurrent form of eczema affecting the scalp and retroauricular regions [1]
We report here a 77-year-old Japanese man, who had been a carrier of HTLV-1 infection and treated for IDH with oral prednisolone for nearly 10 years

Summary

Introduction

Among human T-cell lymphotropic virus type 1 (HTLV-1) infected individuals, adult T-cell leukemia/lymphoma (ATLL), and a chronic neurological disease, the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) are two major symptomatic disorders. Dermatological disorders are noted in 5–10% of the HTLV-1 infected patients [1]. The skin lesions could be either infectious or autoimmune dermatitis [2]. The infective dermatitis associated with HTLV-1 (IDH) is a chronic recurrent form of eczema affecting the scalp and retroauricular regions [1]. IDH may progress to HAM/TSP or to ATLL [3]. Immunological features of IDH are similar to those of HAM/TSP [2]. Expansion of natural killer (NK) cells has rarely been described in patients with IDH

Case Report

Discussion