Paraparesia espástica tropical / mielopatia associada ao HTLV-I: relato de dois casos diagnosticados em Florianópolis, Santa Catarina

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia.

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Paraparesia espástica tropical/ mielopatia associada ao HTLV-I: relato de dois casos diagnosticados em Cuiabá, Mato Grosso

Grzesiuk

Martins

1999

Arq. Neuro-Psiquiatr.

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RESUMO -Descrevemos dois casos clínicos de paraparesia espástica tropical/mielopatia associada ao HTLV-I, obedecendo os critérios da OMS-1989. Estes são os primeiros casos diagnosticados em Cuiabá. Em um dos casos houve resposta clínica ao uso de prednisona. PALAVRAS-CHAVE: paraparesia espástica tropical, HTLV-I, diagnóstico, prednisona. Tropical spastic paraparesis/HTLV-I associated myelopathy: report of two cases diagnosed in Cuiabá, Mato Grosso do Sul, BrazilABSTRACT -We describe two cases of tropical spastic paraparesis/HTLV-I associated myelopathy, according to the criteria of World Health Organization-1989. These are the first cases diagnosed in Cuiabá (Mato Grosso State, Brazil). One of them had a good response with the treatment with prednisone.

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Paraparesia espástica tropical / mielopatia associada ao HTLV-I: relato de dois casos diagnosticados em Florianópolis, Santa Catarina

Cited by 4 publications

References 16 publications

Impact of HTLV-I in quality of life and urogynecologic parameters of women with urinary incontinence

Impact of HTLV-I in quality of life and urogynecologic parameters of women with urinary incontinence

Effect of Pulsed Methylprednisolone on Pain, in Patients with HTLV-1-Associated Myelopathy

Paraparesia espástica tropical/ mielopatia associada ao HTLV-I: relato de dois casos diagnosticados em Cuiabá, Mato Grosso

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