HTLV-I-associated myelopathy: analysis of 213 patients based on clinical features and laboratory findings

Nakagawa, Masanori; Izumo, Shuji; Ijichi, Shinji; Kubota, Hiroaki; Arimura, Kimiyoshi; Kawabata, Masaharu; Osame, Mitsuhiro

doi:10.3109/13550289509111010

Cited by 223 publications

(185 citation statements)

References 54 publications

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“…When the sample was analyzed according to the duration of the disease, from the group Seven subjects used more than one type of walking aids with less than 10 years of disease (n ¼ 31), 10% were restricted to wheelchair, and from the group with more than 10 years of disease (n ¼ 41), 22% were wheelchair bound. These data are similar to those of Nakagawa et al, 20 Araujo et al 21 and Cartier et al 22 The presence of muscle contractures complies with the gait pattern, the adductors being the most frequent involved muscles (83%). There were a minority of subjects with abnormal sensory examination (14%), in whom a distal deficit prevailed.…”

Section: Discussionsupporting

confidence: 90%

Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP)

Franzoi

Araújo

2006

Spinal Cord

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Study design: Cross-sectional. Objectives: The aim of this survey is to describe the disability profile in a group of tropical spastic paraparesis/HTLV-I-associated myelopathy patients, identifying the requirements for community ambulation. Setting: Terciary care unit, Rio de Janeiro, Brazil. Methods: Seventy-two patients were assessed (49 female and 23 male), referred by tertiary care centers, when a clinical protocol was applied. Results: The sample had an average age of 40 years and an average of 137 months of duration of the disease. The most prevalent aspects of disability found were in gait and sphincter control areas. A total of 72% of the patients were community ambulators and 17% were restricted to wheel chair. Age, strength and low-back pain interfere in activities of daily living (Po0.05). A positive correlation was found between community ambulation and the knee extensors (r ¼ 0.80) and ankle plantar flexors (r ¼ 0.74). Strength, age, low-back pain, duration of disease, asymmetric onset of the symptoms and spasticity interfered in the ability to walk (Po0.05). A rehabilitation program was proposed focusing on modifiable factors that affect disability level. Conclusion: It was possible to describe the profile of disability in this group of patients, identifying the requirements to the community ambulation. Sponsorship: Not applicable.Spinal Cord (2007) 45, 64-68.

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Section: Discussionsupporting

confidence: 90%

Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP)

Franzoi

Araújo

2006

Spinal Cord

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“…Nevertheless, patients with acute or subacute evolution over days to weeks have been described [24][25][26][27][28] . The prevalence of subacute evolution was estimated in 7.9% in a reference center for HTLV in Rio de Janeiro, Brazil 28 .…”

Section: Encephalopathy and Cognitive Deficitsmentioning

confidence: 99%

HTLV-1 and neurological conditions: when to suspect and when to order a diagnostic test for HTLV-1 infection?

Araújo

Leite

Lima

et al. 2009

Arq. Neuro-Psiquiatr.

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-HTLV-1 is a retrovirus associated with a myriad of clinical conditions, especially hematological and neurological ones. Regarding nervous system diseases, it is of utmost importance to select those cases in which HTLV-1 infection could really be associated. This is particularly true for patients from endemic areas and for HIV-infected patients and drug users, since that these groups are at a higher risk for HTLV infection. This caution in selecting neurological patients for HTLV diagnostic tests is justified by the fact that in some circumstances the seropositivity may merely represent an epiphenomenon. In this paper we enroll some neurological conditions that have been associated with HTLV-1/2 infection in the literature and discuss the real need for HTLV-1/2 diagnostic tests in each one. Because HIV/HTLV-co-infected patients seem to be at an increased risk for neurological diseases development, a special consideration about this matter is also made.KEy WORDs: HTLV, myelopathy, myopathy, peripheral neuropathy, HIV.doenças neurológicas e infecção pelo HTLV-1: quando suspeitar e quando solicitar testes diagnósticos para a infecção pelo HTLV-1Resumo -O HTLV-1 é um retrovírus associado tanto a doenças hematológicas quanto a doenças neurológicas. Em relação às doenças neurológicas, é fundamental que selecionemos aquelas em que de fato a infecção pelo HTLV-1 possa ser a causa. Isto é particularmente verdadeiro nos pacientes oriundos de áreas endêmicas e nos pacientes infectados pelo HIV e usuários de drogas, haja vista que estes grupos são de risco para infecção pelo HTLV. Este cuidado ao selecionarmos aquelas condições neurológicas que merecem ser investigadas com sorologia para o HTLV se justifica pelo fato de que nem sempre podemos afastar uma associação fortuita entre a infecção e a referida doença. Neste artigo, comentaremos sobre algumas condições neurológicas que podem estar associadas com a infecção pelo HTLV-1/2, discutindo a real necessidade de solicitar testes para o diagnóstico da infecção pelo HTLV-1/2 frente a elas. Uma breve consideração sobre a co-infecção HIV/ HTLV será feita no final deste artigo tendo em vista que estes pacientes apresentam um risco aumentado para o desenvolvimento de doenças neurológicas.PALAVRAs-CHAVE: HTLV, mielopatia, miopatia, neuropatia periférica, HIV.The human T cell lymphotropic virus type 1 (HTLV-1) is a retrovirus and the etiologic agent of both a group of hematological disorders known as Adult T cell leukemia/ lymphoma (ATLL) 1 and a group of neurological conditions known altogether as the HTLV-1 neurological complex 2 , of which the most common is the HTLV-1 associated myelopathy/Tropical spastic paraparesis (HAM/TsP) 3 . Endemic infection with HTLV-1 is now recognized to be worldwide, and is also common in Brazil 4 . The number of people around the world infected with HTLV-1 is estimated as being between 10 to 20 million. There are areas in Japan, sub-saharan Africa, the Caribbean, and south America where more than 1% of the general population is infected. T...

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“…HTLV-I-associated myelopathy (HAM/TSP) is an inflammatory disease of the central nervous system (CNS) with an insidious onset and slowly progressive evolution 1 . The most common neurological manifestations include spastic paraparesis, sphincter dysfunction and sensory impairment.…”

Section: Difficulties In Ham/tsp Diagnosismentioning

confidence: 99%

Difficulties in HAM/TSP diagnosis

Slater

Ribeiro

Puccioni-Sohler

2012

Arq. Neuro-Psiquiatr.

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The World Health Organization recommends the use of Osame's criterion (1990) for the diagnosis of HTLV-I-associated myelopathy (HAM/TSP). In 2006, a group of neurologists developed a Brazilian criterion that can diagnose HAM/TSP from its onset. OBJECTIVE: It was to test the agreement between both criteria. METHODS: The study included evaluation of clinical and laboratory findings of 35 patients. The ELISA, Western blot and/or polymerase chain reaction was used to search for anti-HTLV-I antibodies. The analysis of agreement was based on the calculation of Kappa. RESULTS: Concordance of 100% (Kappa=1) occurred in cases of "defined" HAM/TSP, but not in patients with "probable" diagnosis. CONCLUSION: The Brazilian criteria was as effective as Osame's criteria for the diagnosis of "defined" HAM/TSP. However, both require more specific biological markers in cerebrospinal fluid for the laboratory diagnosis of probable cases.

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HTLV-I-associated myelopathy: analysis of 213 patients based on clinical features and laboratory findings

Cited by 223 publications

References 54 publications

Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP)

Disability and determinants of gait performance in tropical spastic paraparesis/HTLV-I associated myelopathy (HAM/TSP)

HTLV-1 and neurological conditions: when to suspect and when to order a diagnostic test for HTLV-1 infection?

Difficulties in HAM/TSP diagnosis

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