A Human T Lymphotropic Virus Type 1 Carrier Coinfected with Mycobacterium intracellulare and Pneumocystis jirovecii with a Characteristic Compositional Change of Bone Marrow Cells
Human T lymphotropic virus type 1 (HTLV-1) is endemic in the southern part of Japan. Infection of the virus can cause adult T cell leukemia/lymphoma (ATL), while most infected individuals remain in a carrier state for a long period of time. Although rare cases of carriers, like ATL patients, who developed opportunistic infections, have been reported, hematological changes of carriers who are prone to opportunistic infections have not been well defined. Here, we present a case of an HTLV-1 carrier who developed Mycobacterium intracellulare infection and Pneumocystis jirovecii pneumonia (PcP) simultaneously. Flow cytometric analysis of bone marrow cells revealed an aberrant compositional change similar to that in ATL patients. This suggests the presence of a pre-ATL state prior to the development of ATL, which is notable in terms of underlying cellular immunodeficiency.
References
[1]
Utsch, D., Augusto, F., Gabriel, J., Grossi, M., Regina, S., Carlos, A. and Barbara, A. (2010) Epidemiology, Treatment, and Prevention of Human T-Cell Leukemia Virus Type 1-Associated Diseases. Clinical Microbiology Reviews, 23, 577-589.
https://doi.org/10.1128/CMR.00063-09
[2]
Tanaka, T., Sekioka, T., Usui, M. and Imashuku, S. (2015) Opportunistic Infections in Patients with HTLV-1 Infection. Hindawi Publishing Corporation, Cairo, Article ID: 943867. https://doi.org/10.1155/2015/943867
[3]
Marsh, B.J. (1996) Infectious Complications of Human T Cell Leukemia/Lymphoma Virus Type 1 Infection. Clinical Infectious Diseases, 23, 138-145.
https://doi.org/10.1093/clinids/23.1.138
[4]
Tamaki, Y., Higa, F., Tasato, D., Nakamura, H., Uechi, K., Tamayose, M., Haranaga, S., Yara, S., Tateyama, M. and Fujita, J. (2011) Pneumocystis jirovecii Pneumonia and Alveolar Hemorrhage in a Pregnant Woman with Human T Cell Lymphotropic Virus Type-1 Infection. Internal Medicine, 50, 351-354.
https://doi.org/10.2169/internalmedicine.50.4482
[5]
Canelo-Aybar, C., Cuadra-Urteaga, J., Atencia, F. and Romani, F. (2011) Human T Lymphotropic Virus-1 Associated Gastrointestinal Histoplasmosis in Peru. Journal of Infection in Developing Countries, 5, 484-488. https://doi.org/10.3855/jidc.1030
[6]
Shimoyama, M. (1991) Diagnostic Criteria and Classification of Clinical Subtypes of Adult T-Cell Leukemia-Lymphoma: A Report from the Lymphoma Study Group (1984-87). British Journal of Haematology, 79, 428-437.
https://doi.org/10.1111/j.1365-2141.1991.tb08051.x
[7]
Yano, H., Ishida, T., Inagaki, A., Ishii, T., Kusumoto, S., Komatsu, H., Iida, S., Utsunomiya, A. and Ueda, R. (2007) Regulatory T-cell Function of Adult T-Cell Leukemia/Lymphoma Cells. International Journal of Cancer, 120, 2052-2057.
https://doi.org/10.1002/ijc.22536
[8]
Taguchi, H. and Miyoshi, I. (1989) Immune Suppression in HTLV-1 Carriers: A Predictive Sign of Adult T-Cell Leukemia. Acta Medica Okayama, 43, 317-321.
[9]
Kawahigashi, N., Furukawa, Y., Tara, M. and Niina, K. (1996) Pneumocystis Carinii Pneumonia in a HTLV-1 Carrier with Monoclonal Proliferation of HTLV-1 Infected Lymphocyte. Journal of Clinical Hematology, 37, 317-322.
[10]
Okada, F., Ando, Y., Yoshitake, S., Yotsumoto, S., Matsumoto, S., Wakisaka, M., Maeda, T. and Mori, H. (2006) Pulmonary CT Findings in 320 Carriers of Human T-Lymphotropic Virus Type 1. Radiology, 240, 559-564.
https://doi.org/10.1148/radiol.2402050886
[11]
Takasaki, Y., Iwanaga, M., Imaizumi, Y., Tawara, M., Joh, T., Kohno, T., Yamada, Y., Kamihira, S., Ikeda, S., Miyazaki, Y., Tomonaga, M. and Tsukasaki, K. (2010) Long-Term Study of Indolent Adult T-Cell Leukemia-Lymphoma. Blood, 115, 4337-4343. https://doi.org/10.1182/blood-2009-09-242347