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Published 20 August 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.03.2009.1680]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual association of diseases/symptoms

Chronic inflammatory demyelinating polyneuropathy in a patient infected with human T lymphotropic virus type I

Amza Ali1, Gurendra Char2, Barrie Hanchard2

1 University of the West Indies, c/o Epilepsy Centre of Jamaica, 27 Hope Rd, Kingston, 10, Jamaica
2 University of the West Indies, Pathology, University Hospital of West Indies, Kingston, 7, Jamaica

Correspondence to:
Amza Ali, amzamd{at}yahoo.com

SUMMARY

A 32-year-old Afro-Caribbean woman presented with a 1-year history of slowly progressive sensory and motor symptoms initially affecting the legs and later involving the arms. Clinical examination demonstrated a mainly distal pattern of weakness with little objective sensory impairment. The clinical features suggested the possibility of chronic inflammatory demyelinating polyneuropathy. This diagnosis was supported by neurophysiological testing and examination of the cerebrospinal fluid and confirmed by sural nerve biopsy as well as by exclusion of other causes of neuropathy. Seropositivity for human T lymphotropic virus type I (HTLV-I) was demonstrated. The clinical significance of this finding in an area with a high HTLV-I endemicity, as well as its possible aetiological relevance to the diagnosis of chronic inflammatory demyelinating polyneuropathy, is discussed.


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