Abstract
We report the clinical course of a patient with diabetic amyotrophy complicated by HTLV-I-associated myelopathy (HAM). A 63-year-old woman developed diabetes mellitus 9 years ago. Since then, she has been treated with oral glibenclamide (5 mg/day). Her diabetes has been poorly controlled, resulting in severe weight loss (55→34 kg). Muscle atrophy and motor weakness of the lower extremities and a gait disturbance were first noted 2 years age. When she consulted our clinic last year, augmented deep tendon reflexes in the lower extremity were observed. Serum HTLV-I antibody was 32768. A spinal tap showed the following: cells 41/3, protein 57 m/dl, HTLV-I antibody 8194. A diagnosis of HAM was made. Although predonisolone (40 mg/day, P.O.) lowered the HTLV-I titer in cerebro spinal fluid, no major improvement of the gait disturbance was observed. Therefore, the major cause of the walking difficulty may be diabetic amyotrophy. Since HAM has a poor prognosis, further careful observation are required.
