Manifestations of the human T-cell lymphotropic virus type I infection in childhood and adolescence.
OBJECTIVE
To review the literature on diseases linked with infection by human T-cell lymphotropic virus type I (HTLV-I) in childhood and adolescence, with focus on clinical aspects, diagnosis, pathogenesis, progression and treatment.


METHODS
Medical literature published during the last 20 years identified using PubMed and MEDLINE and from specialized medical books, with emphasis on infective dermatitis associated with HTLV-I (IDH), on the juvenile form of HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), on adult T-cell leukemia/lymphoma (ATL) and on HTLV-I-associated uveitis. Keywords used to search databases were: HTLV-I-associated infective dermatitis, HTLV-I-associated myelopathy/tropical spastic paraparesis, adult T-cell leukemia/lymphoma, HTLV-I-associated uveitis.


RESULTS
IDH is a chronic, relapsing and infected dermatitis of childhood which always involves the scalp and which may progress to HAM/TSP and ATL. HAM/TSP is a chronic and incapacitating myelopathy of adults. There are 17 well-documented cases of HAM/TSP in children and adolescents in the literature, 12 of whom are patients with IDH. In contrast with the adult form of the disease, the juvenile form is rapid and progressive. ATL is a type of T-cell leukemia/lymphoma that affects adults and is generally fatal. Eleven of the 24 published reports of ATL in children and adolescents were diagnosed in Brazil.


CONCLUSIONS
These diseases are likely to be more common in childhood and adolescence than the literature would suggest. It is advisable that serological testing be performed for HTLV-I in children and adolescents suffering from chronic and relapsing eczema, with signs and symptoms of myelopathy or with a diagnosis of T-cell leukemia/lymphoma. It is important that pediatricians know how to recognize the pediatric manifestations of this infection in order to correctly diagnose them and offer their patients appropriate guidance and treatment.
Bittencourt
Achiléa Lisboa
AL
Faculdade de Medicina, Universidade Federal da Bahia (UFBA), Salvador, BA, Brazil. achilea@uol.com.br
Primo
Janeusa
J
Oliveira
Maria Fátima Paim de
MF
D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D001942:Breast Feeding; D002648:Child; D003876:Dermatitis, Atopic / Q000175:diagnosis; D003937:Diagnosis, Differential; D004485:Eczema / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015490:HTLV-I Infections / Q000150:complications* / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction; D014786:Vision Disorders / Q000821:virology