RESUMO
From a clinician's point of view, diseases of the immune system are broadly grouped into the following categories: I. Immunodeficiency disorders II.Autoimmune diseases III. Hypersensitivity reactions (AU)
Assuntos
Humanos , Estomatite Aftosa/etiologia , Estomatite Aftosa/diagnóstico , Síndrome de Behçet/diagnóstico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/etiologia , Líquen Plano Bucal/diagnóstico , Líquen Plano Bucal/tratamento farmacológico , Síndrome de Sjogren/diagnóstico , Epidermólise Bolhosa/diagnóstico , Dermatite Herpetiforme , Eritema Multiforme/diagnóstico , Eritema Multiforme/tratamento farmacológicoRESUMO
Human T-cell lymphotropic virus type I (HTLV-I) is associated with adult T-cell leukemia (ATL) and tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). Other inflammatory disorders may occur in HTLV-I-infected patients, such as sicca syndrome resembling Sjogren's syndrome. The sicca syndrome may be the unique clinical manifestation of HTLV-I infection, but is associated frequently with TSP/HAM, which could suggest that sicca syndrome might be an early event in disease progression to TSP/HAM in some cases. We investigated whether peculiar pX and LTR mutations could be related to sicca syndrome, or might argue the existence of clinical progression to TSP/HAM. pX, especially pX(I), pX(II), and pX(IV) ORFs corresponding to Tax cytotoxic T-lymphocyte epitopes, and LTR regions from Caribbean patients who have sicca sydrome with or without TSP/HAM, ATL patients, and healthy carriers were sequenced. The sequences were aligned and compared with ATK-1 prototype and published sequences. LTR sequences exhibited 1.5-2.4 percent of divergence with ATK-1. pX-sequenced regions showed a lower homology within p12(I) encoding sequences. Only few mutations were found within functionally important regions, but were not associated specifically with the clinical status. Finally, no existence of clinical progression to TSP/HAM were found. It would be of interest to study the clinical evolution of HTLV-I-sicca syndrome in patients and to determine HTLV-I sequences from peripheral blood and salivary glands at different stages. Copyright 1999 Wiley-Liss, Inc.(Au)
Assuntos
Idoso , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vírus Linfotrópico T Tipo 1 Humano/genética , Infecções por HTLV-I/virologia , Paraparesia Espástica Tropical/diagnóstico , Análise de Sequência de DNA/métodos , Síndrome de Sjogren/virologia , Sequências Repetidas Terminais/genética , Idoso de 80 Anos ou mais , Sequência de Bases , Região do Caribe , Progressão da Doença , Genoma Viral , Dados de Sequência Molecular , Mutação , Fases de Leitura Aberta/genética , Paraparesia Espástica Tropical/virologia , Alinhamento de SequênciaRESUMO
In this study, evidence for a sicca syndrome was sought in 54 HTLV-1 positive patients of whom 33 (61 percent) were women and 21 (39 percent) were men. Patients who had other known causes of sicca syndrome were excluded from this study. A lacrimal hyosecretion was found in 79 percent of cases. A lacrimal qualitative deficiency was found in 86 percent of patients and a variable intensity coloration with fluorescein and/or Rose Bengal was positive in 83 percent of cases. The histological study of the conjunctivals prints showed an ocular dryness in 65 percent of patients. The labial minor salivary glands biopsy showed a Gougerot-Sjogren syndrome in 78 percent of cases. In our study, a sicca syndrome with varying severity was found in 78 percent of cases (AU)
