Apesar da infecção pelo HTLV-I ser endêmica em várias regiões do mundo, poucos são os relatos da associação entre leucemia-linfoma de células T do adulto (ATLL) e encefalomieloneuropatia pelo HTLV-I. No presente artigo é descrito um paciente que no curso do comprometimento neurológico pelo HTLV-I desenvolveu quadro de leucemia com infiltração de tecido dérmico semelhante ao encontrado na micose fungóide/síndrome de Sézary.

Chronic myelopathy associated with T-lymphotropic virus type I (HAM) has been described as an endemic disease in several areas of the world, meanwhile there are few papers describing the association between HAM and adult T cell leukemia-lymphoma. We report the case of a man that, after four years of progressive spastic paraparesis and neurogenic bladder, developed a clinical picture of a lymphoproliferative disorder characterized by dermal and systemic envolvement, mimicking mycosis fungoides/Sézary syndrome.

A frequência do comprometimento pulmonar em pacientes com doença neurológica associada ao primeiro vírus linfotrópico humano de células T (HTLV-I) tem sido demonstrado por vários autores na África, Ásia e América Latina. Com o objetivo de estudar o envolvimento pulmonar em pacientes com mielopatia por HTLV-I (HAM) estudamos o lavado bronco-alveolar (LBA) de 22 pacientes com HAM e 13 pacientes com mielopatias de outras etiologias. A contagem diferencial das células do LBA de pacientes com HAM demonstrou percentual de linfócitos maior que 20 em 18 (82%) dos pacientes enquanto aqueles com mielopatias de outra natureza mostraram linfocitose no LBA em apenas 2 (15%). Concluímos que o pulmão se constitui em importante órgão para a patogênese de HAM.

Pulmonary involvement in HTLV-I patients has been identified by several authors in Africa, Japan and Brazil. The objective of this controlled study is to establish an association between HAM and lymphocytosis in the bronchoalveolar fluid (BAL). Thirty-five adult patients with non-traumatic and non-tumoral myelopathy filled out a detailed historical survey and underwent a neurological examination, a thoracic radiological evaluation and a CSF examination. Of the patients in this sample, 22 were diagnosed with HTLV-I associated myelopathy and 13 had myelopathies with other etiologies. Lymphocytosis in the BAL fluid was detected in 18 (82%) of the HAM patients and in 2 (15%) of non-HAM patients. We concluded that the lung represents an important organ in the pathogenesis of HAM.