Oneliner_2343

OneLiner

Human T-cell lymphotropic virus (HTLV-1) is an oncogenic virus that causes both adult T-lymphocyte leukemia and HTLV-1-associated myelopathy, also known as tropical spastic paraparesis, involving demyelination. Common manifestations of adult T-lymphocyte leukemia are skin lesions and lytic bone lesions, which can lead to hypercalcemia (as reflected in this patient’s measured calcium level of 13.6). HTLV-1 myelopathy is characterized by myelin destruction within the spinal cord and periventricular regions of the brain. Patients have a progressive course that includes lower extremity weakness, back pain, urinary incontinence, and eventual spastic paraplegia. Cranial nerves and cognitive function often remain intact.