HTLV-1 associated myelopathy diagnosed during lepromatous leprosy reaction treatment: a case report

Abstract

Leprosy and human T cell lymphotropic virus type 1 infection are prevalent in Brazil. Coinfection by Mycobacterium leprae and HTLV-1 is reviewed and a case is reported. A 59 year-old woman was followed and HTLV-1 associated myelopathy was diagnosed during leprosy treatment. The clinical and neurological aspects of this unusual association were initially reviewed. Immunological markers and the possible prognoses due to the association of the diseases were discussed. The unexpected association of leprosy and HTLV-1 associated myelopathy may occur in endemic areas and causes difficulties in determining the correct diagnosis and adequate management of the neurological manifestations. Key-words:Human T-cell lymphotropic virus type 1. Myelopathy. Leprosy. RESUMOHanseníase e infecção pelo HTLV-1 são prevalentes no Brasil. A associação de hanseníase e infecção por HTLV-1 é revista e é relatado um caso de coinfecção. Paciente feminina de 59 anos teve diagnóstico de mielopatia associada ao HTLV-1 durante o tratamento para hanseníase. Aspectos clínicos e neurológicos desta associação, ainda não descrita, são revistos e os marcadores imunológicos e possíveis evoluções relacionadas com a associação dessas doenças discutidos. A associação de hanseníase e mielopatia associada ao HTLV-1, aparentemente pouco usual, pode ocorrer em áreas endêmicas e trazer dificuldades para o diagnóstico e tratamento das manifestações neurológicas. Palavras-chaves:Vírus linfotrópico de células T humanas do tipo 1. Mielopatia. Hanseníase.

Viral Co-infection and Leprosy Outcomes: A Cohort Study

“…However, several studies of HTLV-1 co-infection in leprosy did not refer to any association with clinical outcomes [ 20 ]. A case report from Brazil describes the development of a T2R in a subject presenting with HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) [ 29 ]. We found that co-infection with HTLV-1 is associated with a high rate of unfavorable leprosy outcomes; all co-infected patients had complications, and predominately acute inflammatory episodes (T1R, T2R and neuritis).…”

Leprosy: what is new

“…T1R, T2R, and/or neuritis were detected in 80.5% of coinfected HTLV‐1 and leprosy patients, compared with 68.9% leprosy patients without coinfection 26 . A survival study in the Democratic Republic of the Congo and a prospective study in Brazil found higher risks of nerve function impairment with coinfection 30,31 . Future research should continue to explore endemic viral diseases in leprosy hot spots and potentially severe outcomes.…”

“…26 A survival study in the Democratic Republic of the Congo and a prospective study in Brazil found higher risks of nerve function impairment with coinfection. 30,31 Future research should continue to explore endemic viral diseases in leprosy hot spots and potentially severe outcomes.…”

Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment

“…Leprosy is still present throughout the tropics and subtropics 14 . According to the World Health Organization (WHO), Brazil is among the most endemic countries for Hansen's disease in the world, with 37,610 new cases in 2009 [15][16] ; consequently, the actions for elimination, problem solving, and continuous monitoring must be accelerated and intensified 13 . For the elimination of leprosy, as proposed by the WHO, it is important to redefine the activities for controlling the disease 17 .…”