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Bronchoalveolar Lymphocytosis in Patients with Tropical Spastic Paraparesis Associated with Human T-Cell Lymphotropic Virus Type 1 (HTLV-1): Clinical, Immunologic, and Cytologic Studies

L. J. Couderc, MD; I. Caubarrere, MD; A. Venet, MD; J. Magdeleine, MD; A. Jouanelle, MD; F. Danon, MD; G. Buisson, MD; and J. C. Vernant, MD
[+] Article, Author, and Disclosure Information

Grant Support: Partial support by grants from Le Cercle des Médecins contre les Maladies Rétrovirales and Faculté de Médecine Paris-Ouest.

Requests for Reprints: L. J. Couderc, MD, Service de Pneumonologie, Hôpital Foch, 40 rue Worth, 92151 Suresnes, France.

Current Author Addresses: Drs. Couderc and Caubarrere: Service de Pneumonologie, Hôpital Foch, 92151 Suresnes, France.

Dr. Venet: Inserm U 214, Hôpital Laënnec, 75007 Paris, France.

Dr. Magdeleine: Service de Pneumonologie, Dr. Jouannelle: Service d'Anatomie Pathologique, Drs. Buisson and Vernant: Service de Neurologie, Hôpital La Meynard, Centre Hospitalier de Fort de France, 97200 Martinique, France.

Dr. Danon: Inserm U 108, Hôpital Saint Louis, 75010 Paris, France.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(8):625-628. doi:10.7326/0003-4819-109-8-625
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Study Objective: To determine the features of pulmonary involvement in patients with tropical spastic paraparesis associated with human T-cell lymphotropic virus type 1.

Design: Nonrandomized prospective case series.

Setting: Tertiary care units in two university medical centers.

Patients: Consecutive sample of 21 patients with tropical spastic paraparesis associated with human T-cell lymphotropic virus type 1 infection.

Interventions: Chest roentgenogram and bronchoalveolar lavage were done in all patients. Fifteen patients had pulmonary function tests. Alveolar T-lymphocyte subsets were analysed in 10 patients and thoracic computed tomographic scans were done in 10 patients.

Measurements and Main Results: All patients were free of clinical pulmonary symptoms and had normal chest roentgenograms. Thoracic computed tomographic scans were normal in 9 of 10 patients and showed mild interstitial pneumonitis in 1. Pulmonary function tests were within the normal range in 13 patients and showed a mild restrictive syndrome in 2. Eighteen patients had increased absolute numbers of alveolar lymphocytes (mean, 77 ± 39 × 103 lymphocytes/mL; range, 13.5 × 103 to 259 × 103 lymphocytes/mL). Sixteen patients had percentages of alveolar lymphocytes higher than 20% of all alveolar cells (mean, 33.5 ± 12.7; range, 9 to 69). In all 10 patients tested, 64.2% ± 13.2% of alveolar lymphocytes were CD8+ cells.

Conclusions: Excessive absolute numbers and percentages of alveolar lymphocytes were observed in 18 and 16 patients, respectively. Most alveolar lymphocytes were CD8+ cells.





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