Human T Lymphotropic Virus 1-Associated Myelopathy: Overview of Human T Cell Lymphotropic Virus-1/2 Tests and Potential Biomarkers

Puccioni-Sohler, Márzia; Poton, André Rodrigues; Cabral‐Castro, Mauro Jorge; Yamano, Yoshihisa; Taylor, Graham P.; Casseb, Jorge

doi:10.1089/aid.2022.0028

Cited by 3 publications

(1 citation statement)

References 70 publications

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“…Inflammatory myelopathies constitute the most frequently occurring myelopathies and have diverse immune-mediated disease mechanisms associated with them. With a better understanding of the immune process and the discovery of new disease biomarkers, the diagnostic spectrum of this group of myelopathies continues to expand ( table 1-4 52-59 and table 1-5 60-67 ). The mechanisms of immune-mediated disease include demyelinating disease associated with multiple sclerosis, autoimmune myelopathies associated with specific antibodies against neural antigens (eg, NMO, MOG-associated disorders, paraneoplastic disorders), autoimmune myelopathies related to systemic autoimmune or rheumatologic diseases (eg, Sjögren syndrome, systemic lupus erythematous), infection-associated myelopathies, and other inflammatory myelopathies caused by the use of medications that target immune pathways that trigger autoimmune responses against the spinal cord such as immune checkpoint inhibitors used in cancer treatment 68 or tumor necrosis factor inhibitors in the treatment of rheumatologic disorders 69 …”

Section: An Integrative Approach To Diagnosis Of Myelopathymentioning

confidence: 99%

Clinical Approach to Myelopathy Diagnosis

Pardo

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE This article describes an integrative strategy to evaluate patients with suspected myelopathy, provides advice on diagnostic approach, and outlines the framework for the etiologic diagnosis of myelopathies. LATEST DEVELOPMENTS Advances in diagnostic neuroimaging techniques of the spinal cord and improved understanding of the immune pathogenic mechanisms associated with spinal cord disorders have expanded the knowledge of inflammatory and noninflammatory myelopathies. The discovery of biomarkers of disease, such as anti–aquaporin 4 and anti–myelin oligodendrocyte glycoprotein antibodies involved in myelitis and other immune-related mechanisms, the emergence and identification of infectious disorders that target the spinal cord, and better recognition of myelopathies associated with vascular pathologies have expanded our knowledge about the broad clinical spectrum of myelopathies. ESSENTIAL POINTS Myelopathies include a group of inflammatory and noninflammatory disorders of the spinal cord that exhibit a wide variety of motor, sensory, gait, and sensory disturbances and produce major neurologic disability. Both inflammatory and noninflammatory myelopathies comprise a broad spectrum of pathophysiologic mechanisms and etiologic factors that lead to specific clinical features and presentations. Knowledge of the clinical variety of myelopathies and understanding of strategies for the precise diagnosis, identification of etiologic factors, and implementation of therapies can help improve outcomes.

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Section: An Integrative Approach To Diagnosis Of Myelopathymentioning

confidence: 99%

Clinical Approach to Myelopathy Diagnosis

Pardo

2024

CONTINUUM: Lifelong Learning in Neurology

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HTLV-1-associated myelopathy in Spain

de-Mendoza,

Pérez,

Rando

et al. 2023

Journal of Clinical Virology

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Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil

Dahy

Assone

Marcusso

et al. 2023

Microbiology Research

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Background: During the development of human T-cell lymphotropic virus (HTLV-1)-associated myelopathy (HAM), the inflammatory phenomenon is very prominent and is a major factor in the outcome of the disease. The use of corticosteroids can modify their natural history, and in this study, we evaluated the effectiveness of using daily low-dose prednisone. Methods: This was a cross-sectional study using data collected by physicians monitoring patients with HAM at the Institute of Infectious Diseases “Emilio Ribas”, the main referral center for patients with infectious diseases in São Paulo, Brazil. The objective was to determine if daily low-dose oral prednisone would be able to stabilize the progression of HAM. The outcome measure was a change in the Osame Motor Disability Score (OMDS). Results: Fifty-four patients used treatment with oral prednisone, 5 milligrams daily. Nine cases were excluded from the study because they did not have at least two rating scales within a minimum interval of one year, and six were excluded for being co-infected with HIV and/or HCV. Thirty-nine patients met this criterion and were included for analysis. The majority were women (71.8%), the mean age was 56.51 years old (SD ± 9.74), and the median time of use of prednisone was 16 months. Thirty-two patients (82.05%) maintained the same OMDS, 5/39 (12.82%) had clinical worsening, and 2/39 (5.13%) improved. Conclusions: There was a trend toward clinical stability with the use of oral corticosteroids. However, randomized controlled trials are necessary to evaluate the use in clinical practices in all stages of HAM.

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Human T Lymphotropic Virus 1-Associated Myelopathy: Overview of Human T Cell Lymphotropic Virus-1/2 Tests and Potential Biomarkers

Cited by 3 publications

References 70 publications

Clinical Approach to Myelopathy Diagnosis

Clinical Approach to Myelopathy Diagnosis

HTLV-1-associated myelopathy in Spain

Use of Oral Corticosteroids to Treat HTLV-1-Associated Myelopathy (HAM) in São Paulo, Brazil

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