HTLV-1–associated myelopathy/tropical spastic paraparesis with pseudohypoparathyroidism

Abstract

Article abstract-In many short-stature patients with human T-lymphotrophic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/ TSP), signs and symptoms were manifested during childhood. Successive investigations revealed 12 of 14 short-stature patients with pseudohypoparathyroidism (PHP) from the findings of short metacarpi, parathyroid hormone infusion test, immunoblotting of erythrocyte membrane, or lymphocytic Northern blotting of Gs␣. Patients with PHP probably showed HAM/TSP based on their modified immunologic status. Human T-lymphotrophic virus type I infection did not induce PHP, but PHP may be a risk factor for the occurrence of HAM/TSP.

Endocrine and metabolic disorders in HTLV-1 infected patients

“…In the second article, an additional 11 patients were depicted. 12 In this study, only half of the patients had hypocalcemia, one had hyperphosphatemia and another, elevated PTH. The serum levels of 1,25(OH) 2 vitamin D were tested in three of seven patients.…”

“…60 As for exogenous retrovirus, Lagaye et al detected the presence of sequences of the region gag of the HTLV-1 in patients with polyendocrinopathies. 12 Nevertheless, the search for antibodies to HTLV-1 was negative in all patients. These fi ndings lead the authors to speculate if the tested gag region would belong to only HTLV-1 or it would be a common site to other retrovirus, since other HTLV-1 genomic sites (pol e pX) were negative, not allowing to deduce a causal relationship between HTLV-1 infection and T1DM.…”

“…35 Besides, they report that the HTLV-1 infection is not an inductor factor for PHP, but that PHP is a risk factor for a precocious onset of HAM/TSP in patients infected through blood transfusion, explaining this way the more precocious onset of HAM/TSP in these patients. 12,36 …”

“…7,8 Several studies have been evidencing association between HTLV-1 infection and endocrinopathies and other metabolic disorders such as autoimmune thyroid diseases, hypercalcemia, type 1 diabetes mellitus and pseudohypoparathyroidism. 1,[9][10][11][12] Due to the importance of these disturbances in the clinical spectrum of the HTLV-1 infection, this study aims to review the current knowledge about the endocrine diseases related to the HTLV-1 infection.…”

Manifestações infanto-juvenis da infecção pelo vírus linfotrópico de células T humanas (HTLV-I)

“…67 There are reports of short stature, hypocalcemia, and small increases in urinary phosphorus excretion and of cyclic adenosine monophosphate (AMP) after injection of parathyroid hormone (HPT) in juvenile HAM/TSP, findings which led to the diagnosis of pseudohypoparathyroidism (PHP). 68 According to Machigashira et al, 69 HTLV-I infection does not induce PHP, but PHP may be a risk factor for the development of HAM/TSP in carriers of the virus. This aspect should be investigated more extensively.…”