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Journal of Neurology Neurosurgery and Psychiatry 2002;72:650-652
© 2002 Journal of Neurology Neurosurgery and Psychiatry

SHORT REPORT

Human T cell leukaemia virus type I associated neuromuscular disease causing respiratory failure

E T Littleton1, W D Man1,3, J L Holton2, D N Landon2, M G Hanna1, M I Polkey3, G P Taylor4

1 The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, Queen Square, London, UK
2 Department of Neuropathology, Institute of Neurology, Queen Square, London, UK
3 Respiratory Muscle Laboratories, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, UK
4 Department of Genito-Urinary Medicine and Communicable Diseases, Imperial College School of Medicine, Norfolk Place, London, UK

Correspondence to:
Correspondence to:
Dr Taylor, Department of Genito-Urinary Medicine and Communicable Diseases, Imperial College School of Medicine, Norfolk Place, London W2 1PG, UK


ABSTRACT
Polymyositis and inclusion body myositis have rarely been described in association with human T cell leukaemia virus type I (HTLV-I) infection. Most of such patients have coexisting HTLV-I associated myelopathy (HAM). Two patients with HTLV-I infection, myopathy, and respiratory failure are described. The muscle biopsy specimen of the first patient bore the histological features of inclusion body myositis and there was no evidence of concurrent myelopathy. The second patient had HAM, and her muscle biopsy showed non-specific myopathic and neuropathic changes. Both patients developed respiratory muscle weakness over eight years after diagnosis of myopathy, leading to hypercapnic respiratory failure requiring mechanical ventilatory support. Respiratory failure as a complication of HTLV-I associated myopathy has not previously been described.

Keywords: human T cell leukaemia virus type I (HTLV-I); myopathy; respiratory insufficiency; respiratory function tests

Abbreviations: HTLV-I, human T cell leukaemia virus type I; HAM, HTLV-I associated myelopathy; TSP, tropical spastic paraparesis; PBMC, peripheral blood mononuclear cell




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