POSTPARTUM EXACERBATION OF HTLV-I-ASSOCIATED MYELOPATHY TROPICAL SPASTIC PARAPARESIS FOLLOWED BY AN EPISODE OF PAINLESS THYROIDITIS

A 28-year-old woman noticed a progressive gait disturbance after her first delivery. At the age of 32, the gait disturbance improved during her second pregnancy, but became worse after delivery and eventually resulted in a scissoring gait. At the age of 34, she became transiently thyrotoxic and was diagnosed as having painless thyroiditis and HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP). The findings of this case suggest that the postpartum exacerbation of HAM/TSP was probably due to a rebound phenomenon after immunosuppression during pregnancy, and that the immunological abnormalities associated with HAM/TSP might have played some role in the development of painles thyroiditis.