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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.52 no.3 São Paulo Sept. 1994

https://doi.org/10.1590/S0004-282X1994000300006 

Mielopatias por HTLV-1 na cidade de Salvador, Bahia

 

HTLV-I associated myelopathy in the city of Salvador, Bahia (Brazil)

 

 

Ailton Melo; Irenio Gomes; Kilma Mattos

Unidade de Neuroinfectologia, Universidade Federal da Bahia (UFBA)

 

 


RESUMO

Paraparesia espástica progressiva associada a HTLV-1 constitui-se em uma patologia com características endêmicas em várias regiões do Brasil. Em Salvador, 102 pacientes com mielopatias de diversas etiologias foram triados para HTLV-I/II com ELISA e Western blot em quatro hospitais gerais que assistem a população de baixa renda. Foram encontrados 36 pacientes com mielopatia associada a HTLV-I/II, o que está de acordo com a elevada prevalência dessa patologia em Salvador. Todos os pacientes com infecção pelo HTLV-I/ II apresentavam paraparesia espástica progressiva, bexiga neurogênica associada, a graus variáveis de comprometimento sensitivo superficial e/ou profundo e síndrome do neurônio motor inferior. O exame de LCR mostrou pleocitose linfocitária com aumento moderado de gama-globulinas e a ressonância magnética mostrou graus variáveis de lesões periventriculares e subcorticais associadas ou não a atrofia da medula espinal torácica. O exame neurológico e os dados de ressonância magnética sugerem que os pacientes com comprometimento neurológico por HTLV-I podem estar acometidos por graus variáveis de leucoencefalomieloneuropatia.

Palavras-chave: HTLV-I, paraparesia espástica tropical, TSP HAM, leucoencefalomieloneuropatia.


SUMMARY

Chronic myelopathy associated with human T-lymphotropic virus type I (HTLV-I) has been described in several endemic areas in Brazil. In Salvador, 102 patients with myelopathy were screened for HTLV-I/II by ELISA and Western blot assays. We found 36 patients with HTLV-I/II associated myelopathy confirming the high prevalence of HAM in Salvador. The initial complaint of our patients were urinary urgency, back pain and progressive unsteadiness on walking. On examination all of them had a spastic paraparesis, variable degrees of lower motor neuron syndrome, deep and superficial sensitive syndrome. MRI analysis revealed lesions in the periventricular white matter in addition to atrophy of the thoracic spinal cord. Clinical and magnetic resonance findings reveal that the inflammatory lesions of HAM involve not only the spinal cord but also the brain and peripheral nervous system.

Key-words: HTLV-I, myelopathy, tropical spastic paraparesis, TSP, HAM, leukoencephalomyeloneuropathy.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

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Aceite: 4-dezembro-1993.

 

 

Dr. Ailton Melo - Departamento de Neuropsiquiatria, Faculdade de Medicina, UFBA - Av. Reitor Miguel Calmon s/n - 40110-100 Salvador BA - Brasil.

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