1
|
Montserrat E, Lozano M, Urbano-ispizua A, Matutes E, Feliu E, Ercilla G, Vives-corrons JL, Rozman C. Adult T-cell Leukemia in a Chilean Resident in Spain: Long-Lasting Remission after 2-Deoxycoformycin Treatment. Leuk Lymphoma 2009; 1:47-9. [DOI: 10.3109/10428198909042458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
2
|
Alarcón JO, Friedman HB, Montano SM, Zunt JR, Holmes KK, Quinnan GV. High endemicity of human T-cell lymphotropic virus type 1 among pregnant women in peru. J Acquir Immune Defic Syndr 2006; 42:604-9. [PMID: 16773029 PMCID: PMC2683844 DOI: 10.1097/01.qai.0000221680.52563.d5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human T-cell lymphotropic virus type 1(HTLV-1) is associated with adult T-cell leukemia, tropical spastic paraparesis, and other immune-mediated diseases. There are reports of groups with high prevalences of HTLV-1 infection in Peru, but there is limited knowledge of the epidemiology of infection or which routes of infection are most important. We studied 2,492 women presenting to a large maternity hospital in Lima for prenatal, delivery, or abortion services. HTLV-1 seropositivity was confirmed in 42 women (1.7%; 95% confidence interval, 1.2-2.2). Seroprevalence increased with age but did not vary by region of birth or recency of migration to Lima. Age greater than 30 years and sexual intercourse before 20 years of age were strongly and independently associated with infection. History of abortion and history of transfusion were of borderline significance. Women whose male partner had a characteristic that might be a marker for risk of sexually transmitted infections were also more likely to be infected. HTLV-1 is common among Peruvians throughout the country and is maintained by a low level of neonatally acquired infection that is amplified by sexual transmission. In addition to screening of the blood supply, instituted in 1997, programs designed to reduce neonatal and sexual transmission should be effective.
Collapse
Affiliation(s)
- Jorge O. Alarcón
- Facultad de Medicina/Instituto de Medicina Tropical, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Heidi B. Friedman
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Silvia M. Montano
- Facultad de Medicina/Instituto de Medicina Tropical, Universidad Nacional Mayor de San Marcos, Lima, Peru
- US Naval Medical Research Center Detachment, Lima, Peru
| | - Joseph R. Zunt
- Department of Medicine, University of Washington, Seattle, WA
| | - King K. Holmes
- Department of Medicine, University of Washington, Seattle, WA
| | - Gerald V. Quinnan
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| |
Collapse
|
3
|
do Valle AC, Galhardo MC, Leite AC, Araújo AQ, Cuzzi-Maya T, Maceira JP, de Ameida Dobbin J. Adult T-cell leukemia/lymphoma associated with HTLV-1 infection in a Brazilian adolescent. Rev Inst Med Trop Sao Paulo 2001; 43:283-6. [PMID: 11696852 DOI: 10.1590/s0036-46652001000500009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We present the case of a 15-year-old patient infected with HTLV-1 who developed a cutaneous T-cell lymphoma, confirmed by histopathological and immunohistochemical examination, as well as clinically and hematologically confirmed leukemia. The patient died 3 months after initial presentation of the disease. The rarity of the disease in this age group justifies the present report.
Collapse
Affiliation(s)
- A C do Valle
- Centro de Pesquisa Hospital Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.
| | | | | | | | | | | | | |
Collapse
|
4
|
Gotuzzo E, Arango C, de Queiroz-Campos A, Istúriz RE. Human T-cell lymphotropic virus-I in Latin America. Infect Dis Clin North Am 2000; 14:211-39, x-xi. [PMID: 10738680 DOI: 10.1016/s0891-5520(05)70225-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
HTLV-1 infection is endemic in several Latin American countries. HTLV-1-associated myelophathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia lymphoma (ATLL) are emerging diseases in the region. Documented risk factors for acquiring the virus include breast-feeding, contaminated blood transfusion, and sexual intercourse, all of which are amenable to prevention efforts. Strongyloides stercoralis hyperinfection syndrome and therapeutic failure in apparently healthy patients with nondisseminated strongyloidiasis may be markers of HTLV-1 infection. HTLV-1 co-infection may adversely effect the clinical course of scabies and HIV disease. The new enzyme-linked immunosorbent assays (ELISA) are sensitive and specific, and Western blot technology is reliable for differentiating HTLV-1 from less common HTLV-2. HTLV-1 screening of blood donors and individuals with any disorder that suggests infection has become a necessity in Latin America to prevent the spread of this important emerging pathogen.
Collapse
Affiliation(s)
- E Gotuzzo
- Alexander von Humboldt Institute of Tropical Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru.
| | | | | | | |
Collapse
|
5
|
Gotuzzo E, De Las Casas C, Deza L, Cabrera J, Castañeda C, Watts D. Tropical spastic paraparesis and HTLV-I infection: clinical and epidemiological study in Lima, Peru. J Neurol Sci 1996; 143:114-7. [PMID: 8981307 DOI: 10.1016/s0022-510x(96)00186-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A descriptive study was performed to investigate the epidemiology and clinical features of 50 patients with tropical spastic paraparesis (TSP) associated with HTLV-I infection acquired in Peru. Cases seen at two reference centers in Lima (Alexander von Humboldt Tropical Medicine Institute and Guillermo Almenara National Hospital) between August 1989 and December 1995 are reviewed. All patients had serologic evidence of infection with reactive ELISA tests for HTLV-I, confirmed by positive Western blot assays. The male-female ratio of cases was 1.0:1.78. The mean age at the time of diagnosis was 52.4 years (range: 29 to 73, SD:11.3). A considerable proportion of patients (68%) had lived in Andean regions: this basically due to their native places (48%) because only 8% of cases were referred from these regions. The mean duration of symptoms prior to diagnosis was 4.95 years (range 0.5-22 years). The clinical features at diagnosis included progressive spastic paraparesis (100%) associated with sphincter disturbances (77.7%), paresthesia (61.1%) or lumbar pain (44%). The functional status of all patients was impaired at the time of evaluation: 44.1% walked unaided with a 'scissors-like' gait, 38% used assist devices for walking, 10% used wheelchairs and 8% were bedridden.
Collapse
Affiliation(s)
- E Gotuzzo
- Instituto de Medicina Tropical "Alexander von Humboldt' Universidad Peruana Cayetano Heredia, Honorio Delgado s/n, Lima, Peru
| | | | | | | | | | | |
Collapse
|
6
|
Gotuzzo E, Yamamoto V, Kanna M, Chauca G, Watts DM. Human T-cell lymphotropic virus type I infection among Japanese immigrants in Peru. Int J Infect Dis 1996. [DOI: 10.1016/s1201-9712(96)90056-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
7
|
Haussen SR, de Vecino MC. HTLV-I associated myelopathy/tropical spastic paraparesis. Report of the first cases in Rio Grande do Sul, Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 1995; 53:608-12. [PMID: 8585818 DOI: 10.1590/s0004-282x1995000400010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP), a myelopathy with predominant involvement of the pyramidal tract with minimal sensory loss and associated with HTLV-I infection, endemic in tropical areas, has been identified in four patients in Porto Alegre (RS, Brazil), a temperate zone.
Collapse
Affiliation(s)
- S R Haussen
- Instituto de Neurologia da Irmandade da Santa Casa de Misericórdia de Porto Alegre (INSCMPA), Fundação Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA), Brazil
| | | |
Collapse
|
8
|
Affiliation(s)
- R T Johnson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-7609
| |
Collapse
|
9
|
Rodgers-Johnson PE. Tropical spastic paraparesis/HTLV-I associated myelopathy. Etiology and clinical spectrum. Mol Neurobiol 1994; 8:175-9. [PMID: 7999314 DOI: 10.1007/bf02780668] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In 1985 we had the first indication that human T-cell lymphotropic virus (HTLV-I) was the possible etiological agent of a chronic myelopathy that seemed to be peculiar to the tropics and that is now known as endemic tropical spastic paraparesis (TSP). IgG antibodies to HTLV-I were found in serum and cerebrospinal fluid of patients from Jamaica, Colombia, Martinique, and shortly after in southern Japan, where the disease is called HTLV-I-associated myelopathy (HAM). The HTLV-I seropositivity was first determined by enzyme-linked immunoassay and confirmed by western immunoblot and in the cerebrospinal fluid specific IgG oligoclonal bands to HTLV-I were found in cerebrospinal fluid and not in serum. These laboratory findings indicated that HTLV-I could be neuropathogenic and for the first time a single etiological agent was identified in patients from different countries. Thus, in less than a decade a century of research and speculation was seemingly resolved when this disease, which was thought to occur only in blacks of poor socioeconomic status in tropical countries, was shown to occur in all ethnic groups of varying socioeconomic status in temperate, subtropical, and tropical climates.
Collapse
|
10
|
de Castro-Costa CM, Carton H, Goubau P, de Figueiredo EG, Giffoni SD. [Tropical spastic paraparesis in the tropics and Brazil. A historical analysis]. ARQUIVOS DE NEURO-PSIQUIATRIA 1994; 52:106-9. [PMID: 8002798 DOI: 10.1590/s0004-282x1994000100022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The tropical spastic paraparesis (TSP) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (HTLV-I). This paper aims at delineating the clinico-etiological evolution of this entity. The historical analysis of it showed that the TSP has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and Brazil.
Collapse
Affiliation(s)
- C M de Castro-Costa
- Serviço de Neurologia, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará (UFCE), Fortaleza, Brasil
| | | | | | | | | |
Collapse
|
11
|
Kuroda Y, Matsui M, Takashima H, Kurohara K. Granulocyte-macrophage colony-stimulating factor and interleukin-1 increase in cerebrospinal fluid, but not in serum, of HTLV-I-associated myelopathy. J Neuroimmunol 1993; 45:133-6. [PMID: 8331158 DOI: 10.1016/0165-5728(93)90173-v] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Based on our previous finding of elevated interferon-gamma levels in the cerebrospinal fluid (CSF), but not in serum, of HTLV-I-associated myelopathy (HAM), we assayed serum and CSF levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) in 20 HAM. GM-CSF and IL-1 also increased only in the CSF in 75% and 35%, respectively, of 20 HAM. TNF-alpha was not detected in any of the sera and CSFs. Multiple cytokines may be produced in the central nervous system and play an important role in HAM.
Collapse
Affiliation(s)
- Y Kuroda
- Department of Internal Medicine (Section of Neurology), Saga Medical School, Japan
| | | | | | | |
Collapse
|
12
|
Wignall FS, Hyams KC, Phillips IA, Escamilla J, Tejada A, Li O, Lopez F, Chauca G, Sanchez S, Roberts CR. Sexual transmission of human T-lymphotropic virus type I in Peruvian prostitutes. J Med Virol 1992; 38:44-8. [PMID: 1402830 DOI: 10.1002/jmv.1890380110] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The epidemiology of HTLV-I infection in female prostitutes was studied in a survey of 395 prostitutes from Callao, Peru (the port city of Lima), 72 prostitutes from Iquitos, Peru (another port city on the Amazon River), and 510 prenatal clinic patients from Lima. Prostitutes reported a mean of 8.8 years (range, 1-39 years) of active prostitution and a mean of 205 sexual contacts during the month prior to the study. The percentage of prostitutes with HTLV-I antibody (21.8%) was significantly higher than patients attending a prenatal clinic (3.1%; P less than .0001). The prevalence of HTLV-I antibody increased steadily with age in prostitutes, but no age trend was noted in prenatal patients. By multiple logistic regression analysis, an independent association was found between HTLV-I seropositivity and a history of prostitution in Callao, age, and positive syphilis serology when all 977 study subjects were evaluated. When prostitutes alone were analyzed, the number of years of exposure as a practicing prostitute was associated with HTLV-I seropositivity after controlling for age. These data indicate a greatly increased risk of HTLV-I infection in prostitutes in Callao, Peru, and suggest an association between sexual activity and HTLV-I transmission.
Collapse
Affiliation(s)
- F S Wignall
- U.S. Naval Medical Research Institute Detachment, Lima, Peru
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Kuroda Y, Takashima H, Yukitake M, Sakemi T. Development of HTLV-I-associated myelopathy after blood transfusion in a patient with aplastic anemia and a recipient of a renal transplant. J Neurol Sci 1992; 109:196-9. [PMID: 1634902 DOI: 10.1016/0022-510x(92)90168-k] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We report the development of rapid progressive HTLV-I-associated myelopathy (HAM) after blood transfusion in two immunosuppressed patients, one of whom had aplastic anemia and the other was the recipient of a renal transplant receiving immunosuppressive chemotherapy. Spastic paraparesis developed 11 or 16 months after transfusion and rapidly progressed to a wheelchair-bound state. The present 2 cases suggest that the coexistent immunosuppression may play an important role in the rapid development of HAM in transfusion-acquired cases.
Collapse
Affiliation(s)
- Y Kuroda
- Department of Internal Medicine, Saga Medical School, Japan
| | | | | | | |
Collapse
|
14
|
Kuroda Y, Fujiyama F, Nagumo F. Analysis of factors of relevance to rapid clinical progression in HTLV-I-associated myelopathy. J Neurol Sci 1991; 105:61-6. [PMID: 1795171 DOI: 10.1016/0022-510x(91)90119-r] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In order to clarify factors of relevance to the rapid clinical deterioration in HTLV-I-associated myelopathy (HAM), we analyzed clinical and laboratory parameters of 28 patients. Patients were divided into rapid (n = 14) and slow progression groups (n = 14) by severity of paraparesis in the 5th year after onset. Clinically, only young age at onset of the disease was significantly associated with rapid clinical deterioration. Among laboratory parameters, depressed skin reactions to dinitrochlorobenzene and PPD, a depressed lymphoproliferative responses and increased CSF IgG levels were significantly associated with rapid clinical deterioration. Serum and CSF anti-HTLV-I antibodies titers were not a relevant factor in the rapid clinical deterioration. The results suggest the implication of immunopathogenic mechanisms in HAM.
Collapse
Affiliation(s)
- Y Kuroda
- Department of Internal Medicine (Section of Neurology), Suga Medical School, Japan
| | | | | |
Collapse
|
15
|
Sandler SG, Fang CT, Williams AE. Human T-cell lymphotropic virus type I and II in transfusion medicine. Transfus Med Rev 1991; 5:93-107. [PMID: 1687974 DOI: 10.1016/s0887-7963(91)70197-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
As a consequence of migrating populations, IV drug use and, to a lesser extent, blood transfusions, endemic HTLV-I and HTLV-II infections have spread to nonendemic geographic regions. Although the risk that a person infected with HTLV-I will develop significant disease--even over a lifetime--is estimated to be relatively low, our awareness of the serious diseases associated with other retroviruses requires a cautious approach to blood transfusion. Reports from Japan and the United States indicate that programs testing donated blood and excluding units with HTLV-I antibodies have been highly successful in interrupting the spread of HTLV-I by transfusions. One unanticipated outcome of testing large numbers of people in the United States for HTLV-I antibodies has been recognition of the relatively high prevalence of HTLV-II infection, particularly among IV drug users. The long-term effects of HTLV-II infection are also unknown. Until the natural history and clinical consequences of HTLV-II infection are clearly understood, it is only prudent that blood donated by persons identified to be HTLV-II carriers also be excluded.
Collapse
Affiliation(s)
- S G Sandler
- Blood Services, American Red Cross National Headquarters, Washington, DC 20006
| | | | | |
Collapse
|
16
|
Abstract
In order to assess in vivo cell-mediated immune functions in HTLV-I-associated myelopathy (HAM), we immunized 18 HAM patients with dinitrochlorobenzene (DNCB). Of 18 patients, the skin reaction to DNCB was negative in 15. All those 15 patients also showed anergy to PPD-tuberculin and 9 of 15 patients had a persistent lymphocytopenia (less than 1500/mm3). In vitro lymphoproliferative responses to mitogens, assayed by a flow fluorocytometric method, were also significantly depressed in HAM patients when compared to normal controls. The results thus indicate that cell-mediated immune functions are significantly impaired in HAM patients.
Collapse
|
17
|
|
18
|
Rodgers-Johnson PEB, Garruto RM, Yanagihara R, Gajdusek DC. Human T-lymphotropic virus type I: A retrovirus causing chronic myeloneuropathies in tropical and temperate climates. Am J Hum Biol 1990; 2:429-438. [DOI: 10.1002/ajhb.1310020410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/1989] [Accepted: 03/23/1990] [Indexed: 11/06/2022] Open
|
19
|
Montgomery RD. HTLV-1 and tropical spastic paraparesis. 1. Clinical features, pathology and epidemiology. Trans R Soc Trop Med Hyg 1989; 83:724-8. [PMID: 2617641 DOI: 10.1016/0035-9203(89)90309-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The clinical profile of tropical spastic paraparesis (TSP), described in scattered tropical and subtropical territories over the past 30 years, has been more clearly defined since the discovery of its direct association with human T lymphotropic virus type 1 (HTLV-1). A chronic disease of adults, commoner in women, it usually presents as a progressive spastic paraparesis with sphincter disturbance, sometimes with backache and lower limb sensory disorder. Most cases are chair-bound within 10 years. Histology reveals a chronic lymphocytic meningomyelopathy, predominantly in the spinal cord, together with long tract demyelination and hyalinoid thickening of the media and adventitia of small blood vessels. Geographical areas of high prevalence of TSP are known in the Caribbean, South America, South Africa, southern Japan, the Seychelles and probably in India, and it is sparsely endemic elsewhere. The virus appears to exist within lymphocytes for long periods. Vertical transmission occurs postnatally, and sexual and transfusion infection are also recognized, but much remains to be clarified regarding its pathogenesis and epidemiology.
Collapse
|
20
|
Moore GR, Traugott U, Scheinberg LC, Raine CS. Tropical spastic paraparesis: a model of virus-induced, cytotoxic T-cell-mediated demyelination? Ann Neurol 1989; 26:523-30. [PMID: 2817828 DOI: 10.1002/ana.410260405] [Citation(s) in RCA: 121] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Tropical spastic paraparesis is a neurological disorder that is most commonly seen in certain tropical (mainly Caribbean) areas and that presents as a progressive spastic paraparesis and urinary dysfunction. Recent studies have revealed an association between tropical spastic paraparesis and human T-cell lymphotropic virus type I (HTLV-I) infection. We report the results of a detailed morphological and immunocytochemical study of a patient with tropical spastic paraparesis. Lesions were restricted to the spinal cord and optic nerve, where demyelination, inflammation, and fiber loss were common features. Lymphocytes were seen closely applied to nerve fibers within which were changes resembling those seen in myelinated central nervous system cultures exposed to cytokines. Immunocytochemically, HTLV-I p19 core protein and a predominance of CD8+ (suppressor/cytotoxic) T cells and expression of class I major histocompatibility antigen were demonstrated in spinal cord lesions. It is postulated that cytotoxic T cells, either directly or via cytokines, induce lysis of the myelin sheath and subsequently the axon, resulting in a mixed picture of demyelination and axonal loss with secondary tractal degeneration. Despite this destruction, extensive remyelination was evident within affected areas of spinal cord.
Collapse
Affiliation(s)
- G R Moore
- Department of Pathology (Neuropathology), Albert Einstein College of Medicine, Bronx, NY
| | | | | | | |
Collapse
|
21
|
Itoyama Y, Kira J, Fujii N, Goto I, Yamamoto N. Increases in helper inducer T cells and activated T cells in HTLV-I-associated myelopathy. Ann Neurol 1989; 26:257-62. [PMID: 2528320 DOI: 10.1002/ana.410260212] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Using two-color flow cytometric analysis, we studied peripheral blood lymphocyte subsets in 15 patients with human T-cell lymphotropic virus type I-associated myelopathy. The percentage of CD4+ 4B4+ cells (helper inducer T cell) was significantly increased in the patients with the myelopathy, compared with 16 healthy control subjects who were seronegative for human T-cell lymphotropic virus type I. However, there was no difference in the percentage of CD4+ 2H4+ cells (suppressor inducer T cell) between the two groups. The ratio of CD4+ 4B4+ cells to CD4+ cells and CD4+ 4B4+ to CD4+ 2H4+ cells was also elevated in these patients. The percentage of CD4+ DR+ cells and CD8+ DR+ cells, both of which are phenotypically activated T cells, and the ratio of CD4+ DR+ cells to CD4+ cells and of CD8+ DR+ cells to CD8+ cells are also increased in the patients, compared with the control subjects. The percentage of CD4+ 4B4+ cells showed positive correlations with values of spontaneous proliferation of peripheral blood lymphocytes and serum IgG level in patients with the myelopathy.
Collapse
Affiliation(s)
- Y Itoyama
- Department of Neurology, Kyushu University, Fukuoka, Japan
| | | | | | | | | |
Collapse
|
22
|
Costa CM, Salgueiro MR, Carton H, Do Vale OC, De Arruda AM. Tropical spastic paraparesis in Northeastern Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 1989; 47:134-8. [PMID: 2597006 DOI: 10.1590/s0004-282x1989000200002] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ten possible cases of tropical spastic paraparesis (TSP) in Northeastern Brazil (Ceará) are presented. They show the typical symptoms and signs of TSP consisting of weakness of the lower limbs, spastic gait, hyperreflexia, bladder dysfunction and variable signs of posterior columns impairment. The laboratory examinations excluded other compressive, infective, degenerative or demyelinating lesions of their spinal cord. Our patients age ranged from 21 to 59 years, all were of black origin and all were of lower social class. There was a slight preponderance of females. An etiological implication of a retrovirus (HTLV-I) has been shown for TSP, but for lack of technical conditions we could not determine it in our patients, and that stands as our subsequent step in those and further cases.
Collapse
Affiliation(s)
- C M Costa
- Department of Physiology, Federal University of Ceara, Brazil
| | | | | | | | | |
Collapse
|
23
|
Sarin PS, Rodgers-Johnson P, Sun DK, Thornton AH, Morgan OS, Gibbs WN, Mora C, McKhann G, Gajdusek DC, Gibbs CJ. Comparison of a human T-cell lymphotropic virus type I strain from cerebrospinal fluid of a Jamaican patient with tropical spastic paraparesis with a prototype human T-cell lymphotropic virus type I. Proc Natl Acad Sci U S A 1989; 86:2021-5. [PMID: 2467295 PMCID: PMC286838 DOI: 10.1073/pnas.86.6.2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The isolation and characterization of a human T-cell lymphotropic retrovirus related to human T-cell lymphotropic virus type I (HTLV-I) from cerebrospinal fluid of a Jamaican patient with tropical spastic paraparesis is described. The virus isolate is a typical type C retrovirus as seen by electron microscopy and is related to prototype HTLV-I isolated from patients with adult T-cell leukemia but is not identical to this prototype HTLV-I as seen by restriction enzyme mapping.
Collapse
Affiliation(s)
- P S Sarin
- Laboratory of Tumor Cell Biology, National Cancer Institute, Bethesda, MD 20892
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
|
25
|
Shibasaki H, Endo C, Kuroda Y, Kakigi R, Oda K, Komine S. Clinical picture of HTLV-I associated myelopathy. J Neurol Sci 1988; 87:15-24. [PMID: 3193123 DOI: 10.1016/0022-510x(88)90050-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Clinical and electrophysiological findings in 16 consecutive cases of HTLV-I associated myelopathy are reported. Symmetric spastic paraparesis associated with only mild hyperreflexia in the arms, clinical and electrophysiological evidence of moderate posterior column involvement at the thoracic level, urinary frequency and urgency associated with the detrusor-urethral sphincter dyssynergia but without systemic autonomic involvement, and absence of the segmental grey matter involvement, all suggest the presence of diffuse lesions of the white matter predominantly involving the thoracic cord. We conclude that HTLV-I associated myelopathy is a chronic diffuse leukomyelitis predominantly involving the thoracic cord.
Collapse
Affiliation(s)
- H Shibasaki
- Department of Internal Medicine, Saga Medical School, Japan
| | | | | | | | | | | |
Collapse
|