Infective dermatitis and human T cell lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis in childhood and adolescence.
BACKGROUND
Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (IDH) is a chronic and recurrent eczema occurring during childhood and adolescence. HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic myelopathy of adulthood, presenting with slowly progressive spastic paraparesis and sphincter dysfunction with mild sensory involvement. There are few reports describing an association between IDH and HAM/TSP. The objective of this study was to evaluate the occurrence of HAM/TSP in patients with IDH and in seropositive members of their families and to determine the blood levels of antibodies against HTLV-1 in patients with HAM/TSP.


METHODS
Twenty patients with IDH and their seropositive mothers and siblings underwent clinical, neurological, and laboratory evaluations. The diagnosis of HAM/TSP was made in accordance with the World Health Organization criteria.


RESULTS
Nine individuals had HAM/TSP (6 of the patients with IDH, 2 mothers, and 1 seropositive brother). In 3 families, > 1 individual had HAM/TSP. The serum antibody titers of the patients with HAM/TSP varied from 1 : 3.125 to 1 : 78.125.


CONCLUSIONS
A strong association was observed between IDH and HAM/TSP. The familial clustering of both diseases suggests a genetic background. Serological screening for HTLV-1 in children with symptoms of myelopathy is essential in areas where HTLV-1 is endemic.
Primo
Janeusa Rita L
JR
Department of Medicine, Federal University of Bahia, Bahia, Brazil. janeusa.primo@cpunet.com.br
Brites
Carlos
C
Oliveira
Maria de Fátima S P de
Mde F
Moreno-Carvalho
Otávio
O
Machado
Marcos
M
Bittencourt
Achiléa L
AL
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D002555:Cerebrospinal Fluid / Q000821:virology; D002648:Child; D016000:Cluster Analysis; D003872:Dermatitis / Q000235:genetics / Q000821:virology*; D005190:Family; D005260:Female; D015490:HTLV-I Infections / Q000150:complications* / Q000175:diagnosis / Q000235:genetics*; D015368:Human T-lymphotropic virus 1 / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D015493:Paraparesis, Tropical Spastic / Q000150:complications* / Q000235:genetics*; D017193:Skin Diseases, Viral / Q000150:complications* / Q000235:genetics*
D000914:Antibodies, Viral