title: Postrenal Transplant Human T-Cell Lymphotropic Virus Type I-Associated Myelopathy/Tropical Spastic Paraparesis: A Case Report and Review of the Literature.
abstract: We report a case of human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP), in a 59 year-old, living-donor, renal transplant recipient from Jamaica. The patient's renal transplant had been performed 11 years ago, and her organ donor was also from Jamaica. Pretransplant HTLV-I serologic status for both the donor and recipient was unknown. The prevalence of HTLV-I seropositivity in the United States and Europe is low, and HAM/TSP is a rare occurrence. The positive predictive value of HTLV-I screening in these regions is therefore, low. This has generated debate among transplant societies regarding universal screening for HTLV-I before solid organ transplantation. Very limited evidence is available for the prevention and treatment of this devastating condition. Our case highlights the importance of selected pretransplant screening for HTLV-I infection among organ donors and candidates from endemic areas. We feel such testing may aid in the early recognition of HAM/TSP and more timely initiation of treatment.
authors: Division of Infectious Diseases and Immunology at New York University Langone Medical Center, Department of Medicine, New York University School of Medicine, New York, NY.
authors: Julian Andres
authors: JA
authors: Torres
authors: Division of Infectious Diseases and Immunology at New York University Langone Medical Center, Department of Medicine, New York University School of Medicine, New York, NY.
authors: Sarah
authors: S
authors: Taimur