Highlights the association between HTLV-1 infection and acquired adult myopathy, prompting the recommendation for serological screening for HTLV-1 in cryptogenic adult myopathies.
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HTLV-1 serology warrants consideration in unexplained adult myopathies; this case report leaves the association hypothesis-generating pending confirmatory studies.
We report a 53-year-old Jamaican man with 20 years of progressing weakness involving proximal limb muscles and neck flexors. Serum CK was 1100 IU/L. EMG demonstrated spontaneous activity, myopathic motor units, and full recruitment patterns in weak muscles. Muscle biopsy revealed marked myofiber degeneration with extensive fibrosis, suggesting a chronic myopathic process. HTLV-1 antibody was present in serum in high titers by ELISA and Western blot. Immunohistochemistry with rabbit polyclonal antisera to HTLV-1 showed rare staining myocytes. PCR demonstrated HTLV-1 DNA in frozen muscle tissue. This myopathy, associated with HTLV-1 infection, has clinical and pathological features similar to a dystrophy. We recommend serological screening for HTLV-1 in cryptogenic adult myopathies.
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Dickoff et al. (1993) studied this question.
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