RESUMO
A possible causal association between infective dematitis and HTLV-I infection was reported familial infective dematitis (ID) occurring in a 26-year-old mother and her 9-year-old son. The mother was first diagnosed with ID in 1969 at the age of 2 years in the Dermatology Unit at the University Hospital of the West indies (U.H.W.I.) in Jamaica. The elder of her 2 sons was diagnosed with ID at the age of 3 years, also at U.H.W.I. Both mother and son are HTLV-I-seropositive. A second, younger son, currently age 2 years, is also HTLV-I-seropositive, but without clinical evidence of ID. Major hitocompatibility complex (MHC), class II, human leucocyte antigen (HLA) genotyping documented a shared class II haplotype, DRB*DQBI* (1101-0301), in the mother and her 2 sons. This same haplotype has been described among Japanese patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and has been associated with a possible pathologically heightened immune repsonse to HTLV-I infection. The presence of this haplotype in these familial ID cases with clinical signs of HAM/TSP may have contributed to their risk for development of HAM/TSP. The unaffected, HTLV-I seropositive younger son requires close clinical follow-up. (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Pré-Escolar , Adulto , Relatos de Casos , Dermatite/etiologia , Antígenos HLA-DQ , Antígenos HLA-DR/genética , Infecções por HTLV-I/imunologia , Paraparesia Espástica Tropical/imunologia , Dermatopatias Infecciosas/etiologia , Genótipo , Haplótipos , Teste de Histocompatibilidade , Jamaica , Linhagem , Valor Preditivo dos Testes , Dermatite/genética , Dermatite/imunologia , Infecções por HTLV-I/complicações , Infecções por HTLV-I/genética , Paraparesia Espástica Tropical/imunologiaRESUMO
We determined HLA-antigen frequencies and corresponding relative risks (RR) in 30 Jamaicans with myasthenia gravis (MG) and 40 normal controls.. using a microcytotoxicity assay and commercially prepared typing trays, we found that the strongest HLA associations with MG in Jamaicans were with HLA-A2 (RR = 6.15), HLA-B8 (RR = 3.4), HLA-B13 (RR=7.6), and DQw4 (RR = 3.8). After correction of the P value for the number of antigens tested, only HLA-A2 was stastistically significantly increased in MG patients. There was a statistically significant negative association between Mg and HLA-DR2, as well as as HLA-A9 and -B5. No correlation was observed between HLA phenotype, thymic disease, clinical grades, or disease course. HLA-A2 and sex were independent risk factors for MG, female patients having a higher risk (RR = 5.8). Further studies using larger patient and control groups, locally derived typing sera, and DNA probe analysis are indicated. (AU)