HTLV-I associated myelopathy in Porto Alegre (Southern Brazil).

HTLV-I associated myelopathy/tropical spastic paraparesis (TSP/HAM) have been increasingly described in practically all regions of Brazil. Five confirmed and documented cases of patients with TSP/HAM in Rio Grande do Sul are reported; in all of them spastic paraparesis, neurogenic bladder and superficial and/or profound sensitive disorders were observed in variable degrees. One patient presented a relapsing-remitting course with a cerebellar ataxia (multiple sclerosis-like pattern). Everyone was submitted to clinical, serological, urodynamic, neurophysiologic and neuroradiologic investigation. The aim of this study was to present the southern region of Brazil as an area with significant endemicity for HTLV-I/II infection (prevalence of 0.42% between blood donors), and also to show the existence of patients with neurologic disease associated with this retrovirus.

HTLV-I associated myelopathy in Porto Alegre (Southern Brazil)

Mielotapia associada ao HTLV-I/paraparesia espástica tropical (TSP/HAM) tem sido descrita de forma crescente em praticamente todas as regioes do Brasil. Relatam-se cinco casos confirmados e documentados de pacientes com TSP/HAM no Rio Grande do Sul, observando-se em todos paraparesia espática, bexiga neutrogênica e distúrbios sensitivos superficiais e/ou profundos de graus variáveis. Em um caso denotou-se padrao em surto e remissao, caracterizado por ataxia cerebelar (sugestivo de esclerose múltipla). Os cinco pacientes foram submetidos a investigaçao clínica, laboratorial, urodinâmica, neurofisiológica e de neuroimagem. O objetivo de presente trabalho foi apresentar a regiao sul do Brasil como uma área de significativa endemicidade de infecçao por HTLV-I/II (0,42 por cento de prevalência entre doadores de sangue), bem como evidenciar a existência de pacientes com doença neurológica associada a este retrovírus.

Lymphomatous meningoencephalitis in a patient with HAM/TSP.

A case of lymphomatous meningoencephalitis in a 23 year old Brazilian patient with HTLV-I/II associated myelopathy is reported. The patient was admitted to the hospital with a clinical picture of decreased consciousness level, stiffness of the neck and previous diagnosis of myeloneuropathy. CSF examination showed lymphocytosis with blastic cells and antibodies against HTLV-I/II.

Lymphomatous meningoencephalitis in a patient with HAM/TSP

É descrito o caso de um paciente de 23 anos, com diagnóstico prévio de mielorradiculopatia que desenvolveu diminuiçäo gradual do nível de consciência, rigidez de nuca e cefaléia. O exame do LCR mostrou linfocitose com presença de células blásticas, hiperproteinorraquia e anticorpos para HTLV-I/II

HTLV type I and HTLV type II infection among Indians and natives from Argentina.

Endemic foci for HTLV-II infection have been identified in several Amerindian populations. To determine HTLV-I and/or HTLV-II infection among Amerindians living in Argentina we studied 454 sera or plasmas from Indians and natives from different areas of our country. All samples were tested by the particle agglutination technique, and positive reactions were confirmed by the immunofluorescence assay (IFA). IFA titration was used to differentiate HTLV-I and HTLV-II antibodies. Twenty-three of 222 samples (10.4%) were found positive among the Tobas Indians; 22 samples were typed as HTLV-II and 1 as HTLV-I. Antibodies for HTLV-I were found in the serum and CSF of three natives from Salta with a TSP diagnosis. No positive samples were found among 96 Mapuche Indians and 133 natives from San Luis. Our results indicate that HTLV-II is endemic among the Tobas Indians. In this study, infection by these retroviruses in Argentinian Amerindians seems to have a marked geographic distribution.

HTLV-I-associated neurologic manifestations in four generations of a Brazilian family.

From an index case of tropical spastic paraparesis (TSP), four generations of a Brazilian family of African descent were investigated for human T-lymphotropic virus type I (HTLV-I) infection and its association with neurologic manifestations, as well as the possible routes of transmission. Thirty-two individuals were studied. Polymerase chain reaction (PCR) was used for confirmation of infection. HTLV-I infection was demonstrated in eight subjects (the index case, 6 of 24 blood relatives, and 1 of 7 spouses). The index case and two blood relatives had TSP, whereas subclinical neurologic disturbances were present in three other blood relatives and one spouse. Another member of the family, who had died before this study, had had diagnoses of spastic paraparesis of unknown etiology and small-cell lymphoma. Only 1 of 8 infected individuals was neurologically intact. Of 5 vertically infected individuals, 4 had been breast-fed for long periods (1-2 years). These are the first reported cases of PCR-proved HTLV-I-associated spastic paraparesis in Brazil.