Human T Lymphotropic Virus Type I—Associated Myelopathy

Sheremata, William A.; Berger, Joseph; Harrington, William J.; Ayyar, D. R.; Stafford, M.; DeFreitas, Elaine

doi:10.1001/archneur.1992.00530350027014

Cited by 18 publications

(2 citation statements)

References 44 publications

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“…In contrast to Sheremata et al 18 in which five cases with highest IgG index progressed quickly to a worse incapacity, we did not observe in our patients this association. The CSF analysis of the three control patients with myelopathy of unknown etiology and the seven with idiopathic epilepsy was normal.…”

Section: Commentscontrasting

confidence: 99%

See 1 more Smart Citation

HTLV-I associated myelopathy in patients from Brazil and Iran: neurological manifestations and cerebrospinal fluid findings

Puccioni-Sohler¹,

Kitze

Felgenhauer

1995

Arq. Neuro-Psiquiatr.

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SUMMARY -We analysed sera and cerebrospinal fluid (CSF) of 20 cases of human T-cell lymphotropic virus type (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) from Brazil and Iran and as controls, 16 Brazilian HTLVI seronegative individuals afflicted with other neurological diseases. It was observed in the HAM/TSP patients that: 1) all had an inflammatory reaction within the central nervous system (CNS); 2) 95% (19/20) showed oligoclonal bands reflecting intrathecal IgG synthesis; 3) 85% (17/20) presented a local synthesis of HTLVI antibodies; 4) 35% (7/20) had a measurable immunoglobulin (Ig) synthesis within the CNS. The CSF parameters of the HAM/TSP were compared with the clinical data (age at onset, duration of disease and disability level). Our data prove that CSF analysis is important for the diagnosis of HAM/TSP. There is no association between the severity of the disease and CSF findings.KEY WORDS: HTLV-I, HAM/TSP, cerebrospinal fluid, multiple sclerosis. Mielopatia associada a HTLV-I em pacientes do Brasil e do Irã: manifestações neurológicas e achados no líquido cefalorraquidianoRESUMO -Foram analisadas amostras de líquido cefalorraquidiano (LCR) e plasma de 20 pacientes com mielopatia associada ao HTLV-I (HAM/TSP) provenientes do Brasil e Irã e como controle, 16 de indivíduos brasileiros soronegativos para HTLV-I acometidos por outras doenças neurológicas (esclerose múltipla, epilepsia idiopática e mielopatia de etiologia desconhecida). Observou-se no grupo de pacientes com HAM/TSP: 1) reação inflamatória no SNC em todos os casos; 2) 95% (19/20) mostravam bandas oligoclonais refletindo síntese intratecal de IgG no SNC; 3)85% (7/20) apresentavam síntese local de anticorpos para HTLV-I; 4)35% (tinham síntese mensurável de imunoglobulinas no SNC. Os parâmetros do LCR dos pacientes com HAM/TSP foram comparados aos dados clínicos (idade de início, duração da doença e grau de incapacidade). Os dados apresentados neste estudo indicam a importância da analise do LCR para diagnóstico de HAM/TSP. Entretanto nenhuma associação entre a gravidade da doença e os achados do LCR foi demonstrada.PALAVRAS-CHAVE: HTLV-I, mielopatia, HAM/TSP, líquido cefalorraquidiano, esclerose múltipla.Since the last century, cases of spastic paraparesis with unknown etiology were reported in tropical countries. The presence of HTLV-I antibodies was demonstrated in serum and CSF of patients with this myelopathy in tropical areas and Japan 314 . In the developing countries, where the HTLV-I infection is endemic, HTLV-I associated myelopathy may be difficult to be recognized due to some diagnostic deficiences. Moreover, the clinical course may be similar to other chronic spinal cord

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Section: Commentscontrasting

confidence: 99%

“…The age at onset of our 20 HTLV-I associated myelopathy patients was similar to other reports 18 . We have seen no correlation between a quick course of disease and the earlier age at onset as it was described to some HTLV-I associated myelopathy patients 8 .…”

Section: Commentssupporting

confidence: 89%