Multiple sclerosis, tropical spastic paraparesis and HTLV-1 infection in Afro-Caribbean patients in the United Kingdom.

Abstract

Forty four consecutive patients of AfroCaribbean origin resident in the United Kingdom (UK) were studied, based on a provisional diagnosis of myelopathy of unknown cause, tropical spastic paraparesis (TSP) or multiple sclerosis (MS). Of 30 patients with progressive paraparesis 27 had serum antibodies to HTLV-1 and were classified as having TSP. Fourteen patients fulfilled the criteria for MS and none of 12 tested had HTLV-1 antibodies. All the TSP patients and nine of those with MS were born in the West Indies. Five of the West Indianborn MS patients had migrated to the UK after adolescence but the duration of residence in the UK before symptoms of MS developed was similar to those born in the UK (average 18 years). The features that differentiated MS from TSP patients, apart from HTLV-1 status, included clinical evidence of cranial nerve involvement, more extensive abnormalities on the brain and cervical cord MRI and asymmetry of the VEP latency increase, all of which were more frequent in the MS group. Of the three patients without a diagnosis one, born in the UK, had marked abnormalities on MRI of the brain indistinguishable from those seen in MS.

Cerebrospinal fluid concentrations of soluble CD27 in HTLV-I associated myelopathy and multiple sclerosis

“…In addition, we have shown that CSF-sCD27 concentrations are higher in patients with HAM/TSP than in HTLV-1 carriers or patients with multiple sclerosis. A difference in CSF concentrations of sCD27 between multiple sclerosis and HAM/TSP groups could be related to a higher and more chronic state of immune activation in the latter disease, although a difference in localisation of the inflammatory lesions in either disease could also contribute to this 15. Interestingly, HTLV-I carriers also had slightly higher concentrations of CSF-sCD27 than the OND group (p<0.01).…”

A review of the epidemiological literature on the health of UK-born black caribbeans

“…Rates of gonorrheal infection appear to be higher among Black Caribbean men Caribbeans have a relatively low prevalence, and those who migrated as children do not seem to have a higher risk than those who migrated as adults (Dean & Elian, 1997). Another study (Rudge et al, 1991), however, found that length of residence in the UK of about 20 years might be an important factor. The small number of cases in these studies made it difficult to investigate effects from both age at migration and length of residence with sufficient confidence.…”

An investigation of HLA‐encoded genetic susceptibility to multiple sclerosis in subjects of Asian Indian and Afro‐Caribbean ethnic origin

“…Twenty-five (83%) of the Jamaican MS patients were tested for the presence of antibodies to the HTLV-1 virus to eliminate the possibility of including subjects with tropical spastic paraparesis (an HTLV-1 -linked demyelinating disease which is common among Afro-Caribbean immigrants) ( 12). All of the patients were negative for these antibodies.…”