title: Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?
abstract: The HTLV-1 virus is a known agent involved in the development of HAM/TSP. Past studies have typically observed patients with autonomic dysfunction consisting of detrusor overactivity and detrusor-sphincter dyssynergia, with the occasional observation of underactive detrusor or detrusor arreflexia. However, studies have not yet evaluated the progression of neurogenic bladder over time. In this paper, we describe a HAM/TSP patient with the initial development of overactive detrusor, and subsequent development of detrusor arreflexia. Given a paucity of studies characterizing the effects of HTLV-1 on the autonomic nervous system, particularly aspects controlling continence, this patient's clinical course may represent one type of end point for patients with HAM/TSP and neurogenic bladder. Further cohort or case-series studies, with particular emphasis on the progression of neurogenic bladder, are needed to evaluate the significance of this described case in relation to typical disease progression patterns.
authors.affiliation: Serviço de Imunologia, Hospital Universitário Proffessor Edgard Santos, 5 Andar, Rua João das Botas S/N, Canela, Salvador CEP 40110-160, BA, Brazil.
authors.forename: Matheus
authors.initials: M
authors.lastname: Tannus
authors.forename: Davi
authors.initials: D
authors.lastname: Tanajura
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sundberg
authors.forename: Paulo
authors.initials: P
authors.lastname: Oliveira
authors.forename: Neviton
authors.initials: N
authors.lastname: Castro
authors.forename: André Muniz
authors.initials: AM
authors.lastname: Santos