RESUMO
Reports from Jamaica have indicated that some patients with infective dermatitis or atopic dermatitis (AD) are seropositive for antibodies to human T-lymphotropic virus type 1 (HTLV-1). We describe a 32-year-old Israeli woman with long-term AD and paresthesia in the distal parts of the extremities. Neurological examination revealed a positive Babinski's sign. HLA typing demonstrated that this patient has the common HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis haplotype for DRBI* DQBI*. The presence of HTLV-1 was demonstrated with polymerase chain reaction; HTLV-1-antibodies were detected by the Western blot method and by inoculation of the patient's peripheral blood mononuclear cells into F344 rats. This study confirms the presence of HTLV-1 antibodies and proviral genome in a patient with AD which later evolved into HAM/TSP. We cannot yet conclude whether these two diseases are associated or coincidental disorders.(Au)
Assuntos
Adulto , Ratos , 21003 , Relatos de Casos , Feminino , Humanos , Dermatite Atópica/complicações , Vírus Linfotrópico T Tipo 1 Humano , Infecções por HTLV-I/complicações , Doenças da Medula Espinal/complicações , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Dermatite Atópica/patologia , Hemofilia B , Doença de Depósito de Glicogênio Tipo VI , Modelos Animais de Doenças , Genes/genética , Genes/fisiologia , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Infecções por Deltaretrovirus/sangue , Infecções por Deltaretrovirus/virologia , Reação em Cadeia da Polimerase , Ratos Endogâmicos F344RESUMO
Tropical spastic paraparesis (TSP), a neuromyelopathy predominantly involving the pyramidal tract and commonly observed in tropical and equatorial areas, was recently found to be associated with human T lymphotropic virus type I (HTLV-I). We investigated sera and cerebrospinal fluid (CSF) from 19 patients with TSP who were from the Caribbean area, French Guiana, and Africa. Our results showed an elevated intra-blood-brain barrier IgG synthesis rate and an elevated IgG index, with an increased HTLV-I antibody-to-albumin ratio and the presence of CSF oligoclonal bands in the majority of the patients. These data, in association with similar HTLV-I antibody patterns between patients with TSP who were from these three regions, strenghten the probable etiologic role of HTLV-I in the pathogenesis of such chronic neuromyelopathies. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Anticorpos Antivirais/biossíntese , Infecções por Deltaretrovirus/imunologia , Deltaretrovirus/imunologia , Imunoglobulina G/biossíntese , Paralisia/imunologia , Doenças da Medula Espinal/imunologia , Estudo Comparativo , Anticorpos Antivirais , Barreira Hematoencefálica , Guiana Francesa , Infecções por Deltaretrovirus , Imunoglobulina G , Imunoensaio , Côte d'Ivoire , Espasticidade Muscular , Paralisia , Senegal , Doenças da Medula Espinal , Clima Tropical , Índias OcidentaisRESUMO
Recent neuroepidemiological studies of endemic tropical spastic paraparesis (TSP) have confirmed the existence of high-prevalence foci in several tropical islands, including Jamaica and Martinique in the Caribbean, Tumaco off the Pacific coast of Colombia, and the Seychelles in the Indian Ocean. There is a net preponderance of TSP in persons of Black African ancestry, although Caucasian, Hindu, Amerindian, and Orientals have been affected. The epidemiological, clinical, laboratory, and neuropathological features of TSP are reviewed here, as well as the evidence in favor of its retroviral origin. (AU)
Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Paraparesia Espástica Tropical/epidemiologia , Fatores Etários , Anticorpos Antivirais/análise , Sistema Nervoso Central/patologia , Colômbia , Infecções por Deltaretrovirus/complicações , Espasticidade Muscular/epidemiologia , Espasticidade Muscular/genética , Espasticidade Muscular/imunologia , Espasticidade Muscular/patologia , Paraplegia/genética , Paraplegia/imunologia , Paraplegia/patologia , Fatores Sexuais , Seicheles , Doenças da Medula Espinal/complicações , Clima Tropical , Índias OcidentaisRESUMO
A case of the rare syndrome of spontaneous spinal epidural haematoma is reported. In this patient, the initiating factor appeared to be the vasopressor responses associated with orgasm. A plea is made for greater awareness of this condition in patients with acute transverse myelitis with no obvious cause (AU)