Post-mortem diagnosis of human T lymphotrophic virus type-1 (HTLV-1) associated myelopathy by detection of HTLV-1 DNA in the spinal cord of a patient with post-transfusional myelopathy.

Human T lymphotrophic virus type-1(HTLV-1) is thought to be an etiological agent of HTLV-1 associated myelopathy (HAM). Therefore, a definitive diagnosis of HAM can not be made if information on the presence of antibody against HTLV-1 is not available, even though clinical and histopathological features strongly indicate the disease. In this study, HTLV-1 DNA was detected in the formalin-fixed, paraffin-embedded spinal cord of an autopsy case with post-transfusional myelopathy using the polymerase chain reaction (PCR). Ante-mortem HAM was not suspected of and the antibody has not been examined. Neuropathological examination of the sequential sections revealed a loss of axons and myelin sheaths in the white matter, resembling the histopathology of HAM. The post-mortem detection of HTLV-1 DNA by PCR may be useful for the confirmation of HAM in cases which were not provided with appropriate clinical data.