Progressive myelopathy with hyperintensity on T2-weighted spinal MRI

Abstract

The patient had a high titer of anti-human T lymphotrophic virus type-1 (HTLV-1) antibodies both in the plasma ( 262,144; normal < 16) and in the CSF ( 262,144; normal < 16), on the basis of which HTLV-1 -associated myelopathy (HAM) was diagnosed. Serum concentrations of vitamin B12 (243 pg/mL; normal: 233–914 pg/mL), folate (5.3 ng/mL; normal: 3.6–12.9 ng/mL), and angiotensin-converting enzyme 1 (13.2 U/L; normal: 7.7–29.4 U/ L) were normal. Spinal MRI in patients with HAM is characterized by thoracic cord atrophy without intensity changes and gadolinium enhancement. Recently, however, patients with HAM with high-signal-intensity areas on T2-weighted spinal MRI have been