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EARLY JUVENILE HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE-1-ASSOCIATED MYELOPATHY/TROPICAL SPASTIC PARAPARESIS: STUDY OF 25 PATIENTS
HAM / TSP
Dermatite infecciosa
Agrupamento de HTLV-1
Transmissão vertical
HAM/TSP
Infective dermatitis
HTLV-1 clustering
Vertical transmission
Autor
Afiliación
Hospital Santo Antonio das Obras Sociais Irmã Dulce. Pediatric Neurology Unit. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Department of Pathology. Salvador, BA, Brasil.
Hospital Santo Antonio das Obras Sociais Irmã Dulce. Pediatric Neurology Unit. Salvador, BA, Brasil / Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia Experimental. Salvador, BA, Brasil / Catalan Institute of Oncology. Bellvitge Institute for Biomedical Research. L’Hospitalet del Llobregat. Against Cancer Therapeutic Resistance. Catalonia, Spain.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Department of Pathology. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Department of Pathology. Salvador, BA, Brasil.
Hospital Santo Antonio das Obras Sociais Irmã Dulce. Pediatric Neurology Unit. Salvador, BA, Brasil / Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Internal Medicine. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Patologia Experimental. Salvador, BA, Brasil / Catalan Institute of Oncology. Bellvitge Institute for Biomedical Research. L’Hospitalet del Llobregat. Against Cancer Therapeutic Resistance. Catalonia, Spain.
Federal University of Bahia. Professor Edgard Santos Teaching Hospital. Department of Pathology. Salvador, BA, Brasil.
Resumen en ingles
Human T-cell lymphotropic virus type-1 (HTLV-1) may cause severe diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). The clinical characteristics and progression of 25 early onset HAM/TSP associated or not to IDH were described. Methods. Following-up 37 IDH patients with neurological examinations, 54% developed HAM/TSP. To these cases were added
5 cases of juvenile HAM/TSP. The patients were HTLV-1+ and were submitted to dermatological and neurological examinations.
Diagnosis of HAM/TSP was performed according to Osame et al (1990) and Castro-Costa et al (2006) criteria.
Results. Twenty-one patients were classified as definite HAM/TSP by both criteria, 3 as probable HAM/TSP by Osame et al, and
another as probable HAM/TSP according to Castro-Costa et al Median age at onset of neurological manifestations was 9 years for
the IDH/HAM/TSP group and 16 years for the HAM/TSP group (P = .045). In 12 patients, the onset of neurological manifestations
occurred when they were less than 10 years of age. In the group IDH/HAM/TSP, the neurological symptoms always begun during the
period of activity of IDH. The progression of HAM/TSP evaluated in 17 cases was heterogeneous, and 3 had rapid progressive course.
Conclusions. The juvenile HAM/TSP may occur very early and also presents marked female predominance. Progression of IDH
to HAM/TSP before 19 years of age is frequent (54%). Rapid progressive form may also occur in early HAM/TSP. As juvenile IDH
and HAM/TSP are due to vertical transmission through breastfeeding, it is very important to avoid this pathway of infection.
Palabras clave en portugues
HTLV-1HAM / TSP
Dermatite infecciosa
Agrupamento de HTLV-1
Transmissão vertical
Palabras clave en ingles
HTLV-1HAM/TSP
Infective dermatitis
HTLV-1 clustering
Vertical transmission
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