A 78-year-old man developed paresthesias in the extremities. He was referred to a hospital because of positive anti-human T-cell leukemia virus type-1 (HTLV-1) antibodies in the serum and the presence of abnormal lymphocytes. The patient was diagnosed with chronic-type adult T-cell leukemia. A neurological examination indicated sensory impairment in the distal parts of the extremities with loss of deep tendon reflexes. The nerve conduction study indicated motor and sensory demyelinating polyneuropathy, indicating a diagnosis of HTLV-1-associated demyelinating neuropathy.
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b) Intravenous immunoglobulin
Intravenous immunoglobulin, an immune-modulating blood-derived product, may be beneficial for managing neuropathic pain. It is an effective treatment for certain disorders of the nerve and muscles. Paradoxically intravenous immunoglobulin can exert both pro and anti-inflammatory activities depending on its concentration.
