CLINICAL, MORPHOLOGICAL AND VIROLOGICAL FEATURES OF AN HTLV-I-POSITIVE CASE OF ATL IN A WHITE MAN FROM THE CAUCASUS

An HTLV-I-associated case of adult T-cell leukemia (ATL) was described in a 51-year-old white man, native from Georgia, the former U.S.S.R. Clinical manifestation of the disease (enlarged lymph nodes, bone marr ow and peripheral blood changes, CNS-involvement, cutaneous lesions an d hypercalcemia) as well as laboratory findings were recognized to be very similar to those frequently observed in ATL patients from endemic regions. Mature T-helper surface phenotype detected on peripheral blo od lymphocytes of the patient (OKT3-, OKT4+ and OKT8-) and aggressive course of the disease were also in favour of classical type ATL develo ped in the patient. The HTLV-I antibody presence in an ATL patient was repeatedly confirmed by serological tests (Abbott HTLV-I EIA and Sero dia HTLV-I), immunofluorescence and Western blot assay. The latter rev ealed the presence of a large spectrum of HTLV-I-specific antibodies ( to p19, p24, p26, p28, p32, p36, pr53, gp21, gp46, gp62 and gp68 of HT LV-1). The HTLV-I-specific antibodies have also been detected in serum samples of the patient's wife and son. The presence of HTLV-I proviru s in the primary ATL patient's PBL was clearly demonstrated by PCR and Southern blot analysis. This case, with the HTLV-I infections detecte d in two other family members, suggests that in Europe, HTLV-I-positiv e cases of ATL can occur in virus-infected local people with much wide r distribution than that hitherto supposed.