To the Editor.
—Human T-cell lymphotropic virus type I (HTLV-I)—associated myelopathy (HAM) is a chronic progressive myelopathy characterized by high antibody titers to HTLV-I in the serum and cerebrospinal fluid (CSF), and the presence of adult T-cell leukemia/lymphoma (ATLL) cells in both the peripheral blood and CSF.1 Nagasaki prefecture, located on the Kyushu island of Japan, is one of the endemic areas of ATLL.2 Although familial clusters had been reported in ATLL,3 there have been no reports of familial clusters of HAM. We herewith describe eight patients from four families with HAM without histories of blood transfusion.All eight of the patients who had a gait disturbance of slowly progressive course are illustrated in the Figure. They are from four families. Most of the patients (except for patient 6) also suffered from urinary problems such as frequency, hesitancy, and retention. Neurologic evaluation revealed spastic paraplegia.
Nakamura T, Matsuo H, Shirabe S, et al. Familial Clusters in Human T-Cell Lymphotropic Virus Type I—Associated Myelopathy. Arch Neurol. 1989;46(3):250–251. doi:10.1001/archneur.1989.00520390016006
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