Clinical and demographic features of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Rio de Janeiro, Brazil.
In Rio de Janeiro (RJ) most cases of paraparesis of obscure origin are associated with the human T-cell lymphotropic virus type I (HTLV-I). Thirty-four consecutive patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) from RJ were evaluated. Most patients came from low socio-economic levels. There was no difference in terms of gender. The main affected racial group was white. A history of sexually transmitted diseases was a major risk factor for HAM/TSP and a positive serology for syphilis was found in 26.5% of the patients. The major clinical findings were of a spastic paraparesis with generalized brisk tendon jerks and bilateral Babinki's sign. Sensation was abnormal in 25 patients (73.5%) and five (14.7%) had a sensory level. Three patients (8.8%) had optic atrophy. The cerebrospinal fluid showed a lymphocytic pleocytosis with a mean total protein content of 0.4 g/litre, and an increased intrathecal IgG synthesis in 59.4% of patients. HAM/TSP and multiple sclerosis (MS) occur indigenously in RJ and some HAM/TSP cases can be sometimes confused with MS. Therefore we propose that, in places where MS coexist with HAM/TSP, HTLV-I antibodies should be sought routinely in those MS suspected cases with prominent spastic paraparesis.
Araújo
A de Q
Ade Q
HTLV-associated Neuropathies Unit, Evandro Chagas Hospital, Fiocruz, Brazil.
Alfonso
C R
CR
Schor
D
D
Leite
A C
AC
de Andrada-Serpa
M J
MJ
D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000276:immunology; D005006:Ethnicity; D005260:Female; D005455:Fluorescent Antibody Technique; D015481:HTLV-I Antibodies / Q000302:isolation & purification; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications / Q000175:diagnosis*; D008297:Male; D009460:Neurologic Examination; D015493:Paraparesis, Tropical Spastic / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D010292:Paresthesia / Q000209:etiology; D001405:Reflex, Babinski; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000150:complications; D013587:Syphilis / Q000097:blood
D015481:HTLV-I Antibodies