Indigenous tropical spastic paraparesis in Madrid (Spain). Experience on screening of human T-lymphotropic virus.
We have recently documented a case of tropical spastic paraparesis by HTLV-I in a Spanish patient. HTLV-I infection is rare in Europe, and hardly ever is accompanied by symptoms, but if it does it could trigger a major health issue. This case is presented here, as well as a discussion on the situations in which HTLV-I detection is justified. An analysis was made of the HTLV diagnostic requests at our centre during 2014-2015 (n=123). The diagnostic algorithm was: 1) Enzyme immunoassay, 2) Reverse hybridization, and 3) Proviral DNA detection by PCR. The results showed several situations of HTLV screening, emphasising those related to paraparesis (22%). Seven cases of HTLV-I infection were found: five in patients from endemic regions, one in an HIV-infected patient, and the case of TSP mentioned above. HTLV-I surveillance in non-endemic regions is a challenging issue, as the cost-benefit ratio is not well-established. This case report emphasises the importance of including HTLV within the differential diagnosis of insidious spastic paraparesis.
Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: lugonauta@gmail.com.
Manuel
M
Ponce-Alonso
Servicio de Neurologia, Hospital Universitario Ramón y Cajal, Madrid, España.
Ignacio
I
Del Corral-Corral
Unidad de Retrovirus y Papilomavirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España.
Marta
M
Ortiz-Rivera
Servicio de Neurologia, Hospital Universitario Ramón y Cajal, Madrid, España.
Carla
C
Anciones-Martín
Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, España.
María Luisa
ML
Mateos-Lindemann
D000328:Adult; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis* / Q000821:virology*; D013030:Spain
Cribado donantes; Donor screening; Human T-lymphotropic virus type I; Human T-lymphotropic virus type I prevalence; Paraparesia espástica tropical; Prevalencia del virus linfotrópico de células T humanas; Tropical spastic paraparesis; Virus linfotrópico de células T humanas