1/66. HTLV-I-associated myelopathy following allogeneic bone marrow transplantation.A 39-year-old polytransfused patient with aplastic anemia acquired transfusion-associated HTLV-I infection shortly before transplantation. The patient underwent allogeneic bone marrow transplantation and developed HTLV-I associated myelopathy 3 years later. Clinical abnormalities and a host of atypical findings are presented in the context of previous reports describing uncommon features of the disease.- - - - - - - - - - ranking = 1keywords = myelopathy (Clic here for more details about this article) |
2/66. HTLV-I-associated myelopathy: acute progression and atypical MR findings.We describe serial MR imaging findings in a patient with HTLV-I-associated myelopathy. The patient had acute progression of neurologic symptoms and exhibited swelling of the entire length of the spinal cord with increased T2 signal and contrast enhancement on MR imaging. The spinal cord became atrophic a few years later.- - - - - - - - - - ranking = 1keywords = myelopathy (Clic here for more details about this article) |
3/66. Clinical course of HTLV-I-associated uveitis.PURPOSE: To define the long-term clinical course and visual outcome of human T-cell lymphotrophic virus type I (HTLV-I)-associated uveitis (HAU). methods: We reviewed the clinical data on 96 eyes of 70 patients, 26 men and 44 women, with HAU, with specific reference to recurrence of the disease and long-term visual outcome. The mean follow-up period was 83 months (range, 12-276 months). RESULTS: The mean age of onset was 42.8 years (range, 7-78 years of age), with men presenting at a significantly younger age. Forty-seven patients had isolated HAU; in 10 patients, HTLV-I-associated myelopathy occurred before or after the onset of HAU; in 14 patients, hyperthyroidism had preceded HAU. A single episode of mild to moderate acute uveal inflammation with resolution in a few weeks or more occurred in 44 (62.9%) patients, and multiple episodes in 26 (37.1%), with a mean interval of 16 months (range, 1-250 months), which affected the same eye, fellow eye, or both. The majority of patients had favorable visual outcome at the last examination, whereas only a few patients suffered poor vision resulting from steroid cataract and retinochoroidal degeneration. CONCLUSIONS: The clinical course of HAU is virtually benign and its visual outcome is favorable, although its recurrence is common. The uveitis is usually isolated and affects a portion of otherwise unremarkable HTLV-I carriers, but it may sometimes be manifest as a symptom of syndromic diseases such as HTLV-I-associated myelopathy or hyperthyroidism. This study describes for the first time cases of HAU that occurred many years before manifestation of HTLV-I-associated myelopathy.- - - - - - - - - - ranking = 0.6keywords = myelopathy (Clic here for more details about this article) |
4/66. Atopic dermatitis and HTLV-1-associated myelopathy: associated or coincidental disorders?Reports from jamaica have indicated that some patients with infective dermatitis or atopic dermatitis (AD) are seropositive for antibodies to human T-lymphotropic virus type 1 (HTLV-1). We describe a 32-year-old Israeli woman with long-term AD and paresthesia in the distal parts of the extremities. Neurological examination revealed a positive Babinski's sign. HLA typing demonstrated that this patient has the common HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis haplotype for DRB1* DQB1*. The presence of HTLV-1 was demonstrated with polymerase chain reaction; HTLV-1-antibodies were detected by the Western blot method and by inoculation of the patient's peripheral blood mononuclear cells into F344 rats. This study confirms the presence of HTLV-1 antibodies and proviral genome in a patient with AD which later evolved into HAM/TSP. We cannot yet conclude whether these two diseases are associated or coincidental disorders. copyright (R) 2000 S.Karger AG, Basel- - - - - - - - - - ranking = 467.98354321788keywords = tropical spastic, tropical spastic paraparesis, spastic paraparesis, paraparesis, myelopathy, spastic (Clic here for more details about this article) |
5/66. HTLV-I associated infective dermatitis may be an indolent HTLV-I associated lymphoma.When present for a first time blood donation, a 28-year-old Brazilian white female reported a pruritic eczema of the scalp and retroauricular areas since childhood that had been frequently infected. Her mother had been diagnosed as having HTLV-I-associated myelopathy (HAM), and the patient was found to be a human T-lymphotropic virus type-I (HTLV-I) carrier. The patient had been breast-fed for 6 months. The patient had a complete examination, and a biopsy was taken from eczema in the retroauricular area. The biopsy indicated chronic lymphohistiocytic dermatitis with no abnormal lymphocytes. Eleven months later, the patient had an infiltration in the skin of the retroauricular area and a new biopsy revealed atypical lymphocytes. Nested polymerase chain reaction (PCR) was positive for HTLV-I and immunohistochemistry of the tissue at this time confirmed adult T-cell leukemia/lymphoma (ATLL). Retrospective immunohistochemistry showed that the first fragment submitted from the biopsy 11 months before was also compatible with the diagnosis of ATLL. This case fulfilled all major criteria for diagnosis of HTLV-I-associated infective dermatitis (HTLV-I-ID). We postulate that the patient had indolent ATLL associated with HTLV-I infective dermatitis since childhood. We recommend that tissue immunohistochemistry analysis be done in any patient with HTLV-associated infective dermatitis.- - - - - - - - - - ranking = 0.2keywords = myelopathy (Clic here for more details about this article) |
6/66. In vivo fluctuation of HTLV-I and HTLV-II proviral load in patients receiving antiretroviral drugs.HTLV-I and HTLV-II infect T lymphocytes. A high HTLV-I proviral load in peripheral blood mononuclear cells (PBMCs) has been associated with a higher risk of neurologic disease. For HTLV-II, large numbers of infected lymphocytes might contribute to accelerate the immunodeficiency and increase the risk of neuropathy in HTLV-II/hiv-1 coinfected people. We have examined the impact of antiretroviral drugs on HTLV proviral load, testing longitudinal samples collected from 1 HTLV-I infected patient suffering HTLV-I-associated myelopathy (HAM), and two HTLV-II/ hiv-1 coinfected subjects. The HAM patient showed a reduction greater than 2 log in the peripheral proviral load after being treated with zidovudine and lamivudine. In contrast, potent antiretroviral treatment in hiv-1/HTLV-II coinfected carriers produced an initial increase in the HTLV proviral load, which was followed by a reduction greater than 1 log thereafter. In conclusion, antiretroviral drugs seem to reduce HTLV proviral load, although in hiv-1 coinfected persons a transient increase in HTLV proviral load could reflect the rapid blocking of hiv-1 replication occurring in response to therapy, thus causing an increase in the number of circulating T lymphocytes carrying HTLV proviral dna.- - - - - - - - - - ranking = 0.2keywords = myelopathy (Clic here for more details about this article) |
7/66. High signal in the spinal cord on T2-weighted images in rapidly progressive tropical spastic paraparesis.We report a 59-year-old woman with human T-cell lymphotrophic virus type-I (HTLV-I) associated myelopathy/tropical spastic paraparesis who showed high signal in the cervical and thoracic spinal cord on T2-weighted and contrast enhancement on T1-weighted images.- - - - - - - - - - ranking = 2335.1177160894keywords = tropical spastic, tropical spastic paraparesis, spastic paraparesis, paraparesis, myelopathy, spastic (Clic here for more details about this article) |
8/66. Chronic sensory neuronopathy associated with human T-cell lymphotropic virus type I infection.We described two patients with chronic sensory neuronopathy who had anti-HTLV-I antibody in serum and cerebrospinal fluid but no signs of myelopathy. A sural nerve specimen revealed severe degeneration of myelinated and unmyelinated axons. The second patient had subclinical sjogren's syndrome suggestive of a possible link among human T-cell lymphotropic virus type I (HTLV-I), sjogren's syndrome and sensory neuronopathy, respectively. The broad spectrum of neurologic disorders associated with HTLV-I infection now would include chronic sensory neuronopathy.- - - - - - - - - - ranking = 0.2keywords = myelopathy (Clic here for more details about this article) |
9/66. Severe demyelinating myelopathy with low human T cell lymphotropic virus type 1 expression after transfusion in an immunosuppressed patient.We describe an immunosuppressed patient who developed myelopathy after transfusion with human T cell lymphotropic virus type 1-infected blood products during cardiac transplantation; immunoglobulins and fibrinogen deposition indicated disruption of the blood-brain barrier. The low degree of inflammation and virus expression suggests that demyelination may have been caused by an antibody- and complement-mediated process and by an alteration of the spinal cord microenvironment with activation of microglial cells and astrocytes.- - - - - - - - - - ranking = 1keywords = myelopathy (Clic here for more details about this article) |
10/66. Human T cell leukaemia virus type I associated neuromuscular disease causing respiratory failure.polymyositis and inclusion body myositis have rarely been described in association with human T cell leukaemia virus type I (HTLV-I) infection. Most of such patients have coexisting HTLV-I associated myelopathy (HAM). Two patients with HTLV-I infection, myopathy, and respiratory failure are described. The muscle biopsy specimen of the first patient bore the histological features of inclusion body myositis and there was no evidence of concurrent myelopathy. The second patient had HAM, and her muscle biopsy showed non-specific myopathic and neuropathic changes. Both patients developed respiratory muscle weakness over eight years after diagnosis of myopathy, leading to hypercapnic respiratory failure requiring mechanical ventilatory support. Respiratory failure as a complication of HTLV-I associated myopathy has not previously been described.- - - - - - - - - - ranking = 0.4keywords = myelopathy (Clic here for more details about this article) |
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