Human T-lymphotropic virus type I-associated myelopathy. A case report.

Tropical spastic paraparesis (TSP) has been reported from various parts of the world for several decades. Recently reports have emerged from Japan and also countries in tropical zones associating endemic TSP with abnormally high titres of antibodies to human T-lymphotropic virus type I (HTLV-I). Data indicate that this lymphotropic retrovirus is neuropathogenic, either by direct invasion or via immunopathological mechanisms. A South African man is described who met the diagnostic criteria of TSP. Both serum and cerebrospinal fluid were antibody-positive for HTLV-I. It is possible that HTLV-I infection may be implicated in the 'myelopathies of undetermined cause' that form a substantial subgroup of spinal cord disease occurring in black South Africans.