A Case of Bronchiectasis Accompanied by Ulcerative Colitis (UC) and HTLV-1 Associated Myelopathy (HAM)

• Published in: Nihon Kyōbu Shikkan Gakkai zasshi Vol. 32; no. 4; pp. 358 - 363
• Main Authors: Suzuki, Isamu, Munakata, Mitsuru, Kawakami, Yoshikazu, Watanabe, Naomi, Suzuki, Junichi, Yamaguchi, Etsurou, Fujita, Miri
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japanese Respiratory Society 01.04.1994
• Subjects: Adult; Bronchiectasis; Bronchiectasis - etiology; Colitis, Ulcerative - complications; HTLV-1 associated bronchiolo-alveolar disorder; HTLV-1 associated bronchopneumonopathy; HTLV-1 associated myelopathy; Humans; Male; Paraparesis, Tropical Spastic - complications; Ulcerative colitis
• ISSN: 0301-1542; 1883-471X
• DOI: 10.11389/jjrs1963.32.358

We report a case of bronchiectasis with marked thickening of the respiratory tract wall occurring in a 37-year-old man with UC and HAM. He was diagnosed as UC at age 20. HTLV-1 was presumably transmitted to this patient by means of a blood transfusion he received at around age 30. On admission, chest X-ray films, tomography and CT-scan revealed dilated lumens and thickened airway walls extending from the trachea to subsegmental bronchi. Pulmonary function tests showed hypoxemia and mixed ventilatory disturbance with a predominantly obstructive component. HAM was diagnosed on the basis of neurological examination and cerebrospinal fluid analysis. A biopsy specimen from the carinal mucosa showed marked T cell infiltration. In these T cells, we detected polyclonal integration of HTLV-1 proviral DNA. Some of the infiltrating T cells showed atypia. In recent times, respiratory diseases other than infiltration of adult T-cell leukemia cells or opportunistic infection have been reported in HTLV-1 carriers and new clinical entities designated as HABA (HTLV-1 associated bronchiolo-alveolar disorder) and HBA (HTLV-1 associated bronchopneumonopathy) have been proposed. This case is classified among these new entities, in a broad sense, and is a rare case in that the respiratory disorder is apparently related to UC.