Human T Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis in Sao Paulo, Brazil

Domingues, Renan Barros; Muniz, Marcelo Ramos; Pinho, João Pedro; Bassit, Leda; Jorge, M. L. C.; Alquézar, Aitor; Marchiori, Paulo Eurípedes; Chamone, Dalton F.; Scaff, Milberto

doi:10.1093/clinids/20.6.1540

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…We consider that our sample is similar to others from international (Olindo et al, 2006) and Brazilian studies (Moreno-Carvalho et al, 1992;Araujo et al, 1993;Domingues et al, 1995). HAM/TSP presents an insidious beginning and slow progression, individuals becoming symptomatic in their fourth and fifth decades of life, rarely prior to the age of 20 or after the age of 70.…”

Section: Discussionsupporting

confidence: 62%

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers

Champs

Passos

Carvalho

et al. 2019

International Journal of Infectious Diseases

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Objectives: Myelopathy is a well-established long-term clinical manifestation of HTLV-1 infection. Besides motor dysfunction, cognitive impairment may be another consequence of HTLV-1 infection. Moreover, inflammatory markers may be associated with cognitive impairment in these patients. The present study compared the cognitive performance of HAM/TSP patients with healthy controls and investigated the associations between cognitive performance, proviral load and blood inflammatory markers. Methods: Eighty-three patients fulfilling diagnostic criteria for HAM/TSP were submitted to a comprehensive clinical, cognitive and functional evaluation, brain magnetic resonance imaging and determination of levels of IL-1β, IL-6, TNF-α, immunoglobulins and HTLV-1 proviral load in blood and cerebrospinal fluid. The control group was composed of 88 cognitively healthy subjects, matched for age, sex and educational level. Results: Compared to healthy subjects, HAM/TSP patients displayed significant global cognitive impairment and executive function deficits. HAM/TSP cognitive impairment was significantly associated with altered levels of IgM, IgG, IL-6 and TNF-α in blood. There was no association between HAM/TSP cognitive impairment and HTLV-1 proviral load. Conclusions: This study suggests cognitive impairment may be a long-term clinical manifestation of HTLV-1 infection, which seems to be linked to the persistent inflammatory activity that is found in the disease.

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Section: Discussionsupporting

confidence: 62%

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers

Champs

Passos

Carvalho

et al. 2019

International Journal of Infectious Diseases

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“…Há predominância do sexo feminino sobre o masculino, em proporção de 2:1 a 3:1 12,13 . Os distúrbios de marcha, fraqueza e enrijecimento dos membros inferiores são consequentes à diminuição gradual da força muscular e da espasticidade nos miótomos acometidos [14][15][16][17][18] . O paciente diminui gradativamente a deambulação, necessitando, ao longo do tempo, de auxílio para locomoção (bengalas e andadores) até evoluir para o uso da cadeira de rodas.…”

Section: Métodos Resultadosunclassified

“…Cerca da metade dos pacientes mantém a sensibilidade preservada em todo o corpo e o nível sensitivo mais acometido é o torácico. A tetrahiperreflexia e sinal de Hoffmann positivo são sinais frequentes, apesar do pouco acometimento da força muscular e da sensibilidade dos membros superiores, com resultado compatível com o descrito em publicações anteriores 6,14 . Nota-se a importante prevalência da disfunção erétil nos pacientes masculinos, problema grave que deve ser abordado 30 .…”

Section: Discussionunclassified

Mielopatia associada ao HTLV-1: análise clínico-epidemiológica em uma série de casos de 10 anos

Champs

Passos

Barreto

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introdução: A mielopatia associada ao retrovírus HTLV-1 (HAM/TSP) é uma doença progressiva e incapacitante. O objetivo deste trabalho é determinar características clínico-epidemiológicas de pacientes com HAM/TSP. Métodos: Série de casos admitidos de 01/1998 a 12/ 2007, em hospital de reabilitação utilizando os critérios diagnósticos de HAM/TSP. Resultados: Participaram 206 pacientes, dos quais, 67% eram mulheres, com 53 anos de média de idade, nove anos de média de duração de doença. Os sintomas mais frequentes foram a diminuição da força em membros inferiores, espasticidade, dor, presença de bexiga neurogênica e a constipação intestinal. Os sinais neurológicos foram hiperreflexia, Babinsky, Hoffmann e neuropatia periférica. A presença de dor, de espasticidade muscular e de atrofia medular à ressonância nuclear magnética de medula espinhal foram associadas à duração da doença (p<0,05). Conclusões: A HAM/TSP é uma doença de curso incapacitante e progressiva, em que a dor é relatada precocemente, enquanto a atrofia medular torácica e a espasticidade surgem em fase mais tardia. Existem casos de HAM/TSP com provável transmissão do vírus por via vertical. Palavras-chaves:Epidemiologia. Vírus linfotrófico de células T humana tipo 1. Paraparesia espástica tropical. ABSTRACTIntroduction: Human T cell lymphotropic virus type 1 (HTLV-I) myelopathy (HAM/TSP) is a progressive disabling disorder. This work aimed to analyze clinical features and epidemiology in a sample of HAM/TSP. Methods: All HTLV-1 infected patients with diagnostic criteria for HAM/TSP, consecutively admitted to the Sarah Hospital from 1998 to 2007, were included in the study. Results: 206 patients (67% females; mean age: 53.8 years-old) were diagnosed with HAM/TSP. The mean time of evolution was 9.0 years. The most common neurological symptoms were chronic progressive spastic paraparesis, spasticity, pain, neurogenic bladder and neurogenic bowel. The neurological findings were hyperreflexia, Babinsky, Hoffman and peripheral neuropathy. Pain, spasticity and spinal cord atrophy, observed in MRI, were associated with time of disease (p<0.05). Conclusions: HAM/TSP is a very disabling disorder, in which pain is reported early, while spasticity and thoracic spinal cord atrophy appear in a later phase of the disease. Cases of HAM/TSP exist with a probable vertical viral transmission.

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Human T Cell Leukemia/Lymphoma Viruses (HTLV-1 and -2)

Craighead

2000

Pathology and Pathogenesis of Human Viral Disease

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Human T Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis in Sao Paulo, Brazil

Cited by 6 publications

References 14 publications

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers

Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers

Mielopatia associada ao HTLV-1: análise clínico-epidemiológica em uma série de casos de 10 anos

Human T Cell Leukemia/Lymphoma Viruses (HTLV-1 and -2)

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