HTLV-1-associated myelopathy in a solid organ transplant recipient.
Human T-cell lymphotropic virus type-1 (HTLV-1) is endemic in Japan, the Caribbean and in South American countries such as Ecuador. This virus is the cause of HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), a myelopathy characterised by chronic progressive paraparesis, spasticity and urinary symptoms. We report the case of a 40-year-old man who received a kidney transplant from a living donor and developed HAM/TSP, 24 months after transplant. The diagnosis was confirmed by detection of HTLV-1 in blood and cerebrospinal fluid by the ELISA and Western Blot tests. For myelopathy, the patient was treated with pulse methylprednisolone, but had poor response to treatment. We recommend that all patients receiving transplants and their donors who come from endemic countries be given a mandatory screening for HTLV-1 through an ELISA test, in an effort to inform candidates for renal transplantation of the potential risk of infection and the development of this disease.
Department of Nephrology, Hospital de Niños Baca Ortiz, Quito, Pichincha, Ecuador.
Maria Jose
MJ
Montesdeoca Andrade
Department of Neurology, Hospital Carlos Andrade Marin, Quito, Pichincha, Ecuador.
Edgar Patricio
EP
Correa Diaz
Department of Neurology, Hospital Carlos Andrade Marin, Quito, Pichincha, Ecuador.
Maria Eugenia
ME
Buestán
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D004484:Ecuador; D019353:Endemic Diseases; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000097:blood / Q000175:diagnosis*; D066027:Transplant Recipients