Guia de manejo clínico do paciente com HTLV: aspectos neurológicos

Castro-Costa, Carlos Maurício de; Araújo, Abelardo; Menna-Barreto, Marcio; Penalva-de-Oliveira, Augusto César

doi:10.1590/s0004-282x2005000300036

Cited by 13 publications

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“…The disease is characterized by weakness and muscle spasticity in the lower limbs with insidious onset. Neurogenic bladder and bowel disorders, sexual dysfunction and back pain have been also reported 1,2 . Reduced muscle strength, spasticity, old age, back pain and long disease duration may interfere in the gait 5 .…”

mentioning

confidence: 99%

Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Caiafa

Orsini

Felício

et al. 2016

Arq. Neuro-Psiquiatr.

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HTLV-1-associated myelopathy is a progressive disabling disease associated with gait abnormalities. Objective To identify and quantify the main muscles affected by weakness and spasticity, their impact on gait, functional capacity and on quality of life of HTLV-1-associated myelopathy patients. Method We evaluated lower limbs muscular strength according to the Medical Research Council scale, spasticity according to the modified Ashworth scale, daily activities according to the Barthel Index and quality of life according to the Short-Form Health Survey-36 of 26 HTLV-1-associated myelopathy patients. Results The muscles most affected by weakness included the dorsal flexors and knee flexors. Spasticity predominated in the hip adductor muscles and in plantar flexors. Assistance for locomotion, minimal dependence in daily activities, limitations in functional capacity and physical aspects were the most common findings. Conclusion The impairment of gait, functional dependence and quality of life were predominantly a consequence of intense muscle weakness in HTLV-1-associated myelopathy patients.

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confidence: 99%

Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Caiafa

Orsini

Felício

et al. 2016

Arq. Neuro-Psiquiatr.

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“…Therapy with immunossuppressants and immunomodulators, specially corticosteroids, are used as support for the stabilization of the clinical picture 11,12 . Despite reports in the medical literature of similar cases of the association of polymyositis with HTLV-1, the alleged relation of cause and effect has not yet been defined.…”

Section: Discussionmentioning

confidence: 99%

Polymyositis in childhood as clinical manifestation associated with HTLV-1

Ferreira¹,

Costa

Dantas

et al. 2010

Arq. Neuro-Psiquiatr.

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“…Clinical variables concerning neurological, dermatological, ophthalmological, rheumatologic, urological and buccal aspects were stored in a previously validated electronic database using RedCap® [26]. People living with HTLV-1 were classified at recruitment as asymptomatic or HAM/TSP, according to the diagnostic criteria proposed by Castro-Costa et al [27]. HAM/TSP severity was assessed by Osame motor disability scale (OMDS) [28].…”

Section: Clinical Follow-upmentioning

confidence: 99%

Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil

Marcusso¹,

Weyenbergh²,

Moura³

et al. 2019

Preprint

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BACKGROUND: During the natural history, the incidence HTLV-1 related diseases were 0.5% until 10% after decades of infection. Despite relative low lethality, previous study observed that HTLV-1 infection is associated with significantly increased mortality. For example, the incidence of ATLL and HAM/TSP, co-infections with HIV and HCV, parasitic co-infection with Strongyloides stercoralis may increase morbidity and mortality. OBJECTIVE: Determine the mortality rate and its major variables as possible risk factors, analyzing the HTLV Clinic at Emilio Ribas Institute, a continuous open cohort of HTLV patients since 1997. METHODS: This cohort open cohort possesses new patients added at a rate of approximately 50 patients/year. There were 1100 HTLV-infected subjects identified by September 30th 2018. All clinical data including clinical and laboratory data, which have been updated on a regular basis over the last 22 years, were entered into a specific REDCap database. The Ethical Board of the IIER approved the protocol. RESULTS: Along 22 years of clinical care in the HTLV-out clinic, 727 HTLV-1-infected subjects and 248 HAM/TSP cases. Four-hundred sixty-eight patients of whom remaining under active follow up. The mean follow-up time of the cohort was 12 years. Twenty-seven patients died (median age of 51,5 years old). From this total, 13 was asymptomatic carriers and 14 HAM/TSP subjects, 12 of asymptomatic and seven HAM/TSP possess co-infected with HIV or/and HCV. Other seven presented HAM/TSP without co-infection, and all was female, and sepsis was the majority cases the majority of cases of sepsis were related to infection of the urinary tract (p=0.058) and to ulcers of decubitus (p=0.021), and it was associated with risk factors for mortality. CONCLUSIONS: Overall, the mortality rate for HAM-TSP patients was six percent. The mean life expectancy in Brazil is about 78 years in 2018, twenty-two years higher than HAM/TSP patients without any other coinfection. This study highlights the possibility of higher death risk among HTLV-1-infected patients and HAM/TSP subjects in Brazil, and identified some risk factors for this outcome. Also, these patients may possess higher risk for morbidity, usually urinary tract infections and decubitus scars, which could increase risk for death.

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Guia de manejo clínico do paciente com HTLV: aspectos neurológicos

Cited by 13 publications

References 0 publications

Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Polymyositis in childhood as clinical manifestation associated with HTLV-1

Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil

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Guia de manejo clínico do paciente com HTLV: aspectos neurológicos

Cited by 13 publications

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Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

Polymyositis in childhood as clinical manifestation associated with HTLV-1

Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in S&atilde;o Paulo, Brazil

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Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil