Pulmonary involvement in patients with HTLV-I associated myelopathy

Mattos, Kilma; Melo, Ailton; Publio, Conceição Queiroz Leandro; Peçanha-Martins, Antonio Carlos; Freitas, Virgínia; Gomes, Irenio

doi:10.1590/S0004-282X1995000500009

Abstracts

Pulmonary involvement in HTLV-I patients has been identified by several authors in Africa, Japan and Brazil. The objective of this controlled study is to establish an association between HAM and lymphocytosis in the bronchoalveolar fluid (BAL). Thirty-five adult patients with non-traumatic and non-tumoral myelopathy filled out a detailed historical survey and underwent a neurological examination, a thoracic radiological evaluation and a CSF examination. Of the patients in this sample, 22 were diagnosed with HTLV-I associated myelopathy and 13 had myelopathies with other etiologies. Lymphocytosis in the BAL fluid was detected in 18 (82%) of the HAM patients and in 2 (15%) of non-HAM patients. We concluded that the lung represents an important organ in the pathogenesis of HAM.

HTLV-I; TSP; encephalomyeloneuropathy; myelopathy; HTLV-I associated myelopathy (HAM); alveolitis

A frequência do comprometimento pulmonar em pacientes com doença neurológica associada ao primeiro vírus linfotrópico humano de células T (HTLV-I) tem sido demonstrado por vários autores na África, Ásia e América Latina. Com o objetivo de estudar o envolvimento pulmonar em pacientes com mielopatia por HTLV-I (HAM) estudamos o lavado bronco-alveolar (LBA) de 22 pacientes com HAM e 13 pacientes com mielopatias de outras etiologias. A contagem diferencial das células do LBA de pacientes com HAM demonstrou percentual de linfócitos maior que 20 em 18 (82%) dos pacientes enquanto aqueles com mielopatias de outra natureza mostraram linfocitose no LBA em apenas 2 (15%). Concluímos que o pulmão se constitui em importante órgão para a patogênese de HAM.

HTLV-I; TSP; encefalomieloneuropatia; mielopatia; HAM; alveolites

Pulmonary involvement in patients with HTLV-I associated myelopathy

Comprometimento pulmonar em pacientes com mielopatia associada ao HTLV-I

Kilma Mattos; Ailton Melo; Conceição Queiroz Leandro Publio; Antonio Carlos Peçanha-Martins; Virgínia Freitas, Irenio Gomes

Federal University of Bahia (UFBA). This study was partially supported by a grant from the Conselho Nacional de Pesquisa (CNPq)

SUMMARY

Pulmonary involvement in HTLV-I patients has been identified by several authors in Africa, Japan and Brazil. The objective of this controlled study is to establish an association between HAM and lymphocytosis in the bronchoalveolar fluid (BAL). Thirty-five adult patients with non-traumatic and non-tumoral myelopathy filled out a detailed historical survey and underwent a neurological examination, a thoracic radiological evaluation and a CSF examination. Of the patients in this sample, 22 were diagnosed with HTLV-I associated myelopathy and 13 had myelopathies with other etiologies. Lymphocytosis in the BAL fluid was detected in 18 (82%) of the HAM patients and in 2 (15%) of non-HAM patients. We concluded that the lung represents an important organ in the pathogenesis of HAM.

Key words:HTLV-I, TSP, encephalomyeloneuropathy, myelopathy, HTLV-I associated myelopathy (HAM), alveolitis.

RESUMO

A frequência do comprometimento pulmonar em pacientes com doença neurológica associada ao primeiro vírus linfotrópico humano de células T (HTLV-I) tem sido demonstrado por vários autores na África, Ásia e América Latina. Com o objetivo de estudar o envolvimento pulmonar em pacientes com mielopatia por HTLV-I (HAM) estudamos o lavado bronco-alveolar (LBA) de 22 pacientes com HAM e 13 pacientes com mielopatias de outras etiologias. A contagem diferencial das células do LBA de pacientes com HAM demonstrou percentual de linfócitos maior que 20 em 18 (82%) dos pacientes enquanto aqueles com mielopatias de outra natureza mostraram linfocitose no LBA em apenas 2 (15%). Concluímos que o pulmão se constitui em importante órgão para a patogênese de HAM.

Palavras-chave: HTLV-I, TSP, encefalomieloneuropatia, mielopatia, HAM, alveolites.

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Acknowledgements - We are indebted to Laboratório de Imunologia of the Federal University of Bahia for the techinical immunological assistance.

Aceite: 29-junho-1995.

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

1. Couderc LJ, Caubarrere I, Venet A, Magdeleine J, Jouanelle A, Danon F, Buisson G, Vernant JC. Bronchoalveolar lymphocytosis in patients with tropical spastic paraparesis associated with human T-cell lymphotropic virus type-I (HTLV-I). Ann Intern Med 1988, 109:625-628.
2. Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A, De Thé G. Antibodies to human T-lymphotropic virus type I in patients with tropical spastic paraparesis. Lancet 1985, 2:407-410.
3. Gessain A, Gout O. Chronic myelopathy associated with human T-lymphotropic virus type I (HTLV-I). Ann Intern Med 1992, 117:933-946.
4. Higuchi I, Montemayor ES, Izumo S, Inose M, Osame M. Immunohistochemical characteristics of polymiositis in patients with HTLV-I associated myelopathy and HTLV-I carriers. Muscle and Nerve 1993, 16:472-476.
5. Jacobson S, Gupta A, Mattson D, Mingioli E, McFarlin DE. Immunological studies in tropical spastic paraparesis. Ann Neurol 1990, 27:149-156.
6. Kano M, Mitsuhata Y, Kishida S, Yano Y, Muro T, Shy-Drager syndrome and human T-lymphotropic virus infection. Ann Neurol 1989, 25:420-421.
7. Lessa I, Moraes D, Meireles A, Melo A. HTLV-I and myelopathy in Salvador (Northeastern Brazil): a case-control study. Arq Neuropsiquiatr 1993, 51:447-451.
8. Mattos K, Queiroz C, Peçanha-Martins AC, Publio L, Melo A. Lymphocyte alveolitis in HAM/TSP patients. Arq Neuropsiquiatr 1993, 51:134-136.
9. Melo A, Gomes I, Mattos K. Mielopatias por HTLV-I na cidade de Salvador, Bahia. Arq Neuropsiquiatr 1994, 52:320-325.
10. Mita S, Sugimoto M, Nakamura M, Murakami T, Tokunaga M, Uyama E, Araki S. Increased human T-lymphotropic virus type-I (HTLV-I) proviral DNA in peripheral blood mononuclear cells and bronchoalveolar lavage cells from Japanese patients with HTLV-I associated myelopathy. Am J Trop Med Hyg 1993, 48:170-177.
11. Moreira ED Jr, Ribeiro TT, Swanson P, Sampaio C, Melo A, Brites C, Badaró R, Toedter G, Lee H, Harrington W Jr. Seroepidemiology of human T-cell lymphotropic virus type I/II in Northeastern Brazil. J AIDS 1993, 6: 959-963.
12. Osame M, Igata A, Matsumoto M, Kohka M, Usuku K, Izumo S. HTLV-I associated myelopathy (HAM): treatment trial, retrospective survey and clinical and laboratory findings. Hematol Rev 1990, 3:271-284.
13. Osame M, McArthur JC. Neurologic manifestations of infection with human T-cell lymphotropic virus type I. In Asbury AK, McKhann GM, McDonald Wl.(eds). Disease of the nervous systemxlinical neurobiology Philadelphia Saunders,1992 p 1331-1339.
14. Sugimoto M, NakashimaH, Kawano O, Ando M, Araki S. Bronchoalveolar T-lymphocytosis in HTLV-I associated myelopathy. Chest 1989, 95:708.
15. Sugimoto M, Imamura F, Matsumoto M, Sonoda E, Cho I, Ando M. Pulmonary involvement in patients with human T-lymphotropic virus type I-associated myelopathy: the presence of specific IgA antibody in bronchoalveolar lavage fluid. Am J Trop Med Hyg 1993, 48:803-811.

Publication Dates

Publication in this collection
08 Dec 2010
Date of issue
Dec 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Couderc LJ, Caubarrere I, Venet A, Magdeleine J, Jouanelle A, Danon F, Buisson G, Vernant JC. Bronchoalveolar lymphocytosis in patients with tropical spastic paraparesis associated with human T-cell lymphotropic virus type-I (HTLV-I). Ann Intern Med 1988, 109:625-628.

[2] 2. Gessain A, Barin F, Vernant JC, Gout O, Maurs L, Calender A, De Thé G. Antibodies to human T-lymphotropic virus type I in patients with tropical spastic paraparesis. Lancet 1985, 2:407-410.

[3] 3. Gessain A, Gout O. Chronic myelopathy associated with human T-lymphotropic virus type I (HTLV-I). Ann Intern Med 1992, 117:933-946.

[4] 4. Higuchi I, Montemayor ES, Izumo S, Inose M, Osame M. Immunohistochemical characteristics of polymiositis in patients with HTLV-I associated myelopathy and HTLV-I carriers. Muscle and Nerve 1993, 16:472-476.

[5] 5. Jacobson S, Gupta A, Mattson D, Mingioli E, McFarlin DE. Immunological studies in tropical spastic paraparesis. Ann Neurol 1990, 27:149-156.

[6] 6. Kano M, Mitsuhata Y, Kishida S, Yano Y, Muro T, Shy-Drager syndrome and human T-lymphotropic virus infection. Ann Neurol 1989, 25:420-421.

[7] 7. Lessa I, Moraes D, Meireles A, Melo A. HTLV-I and myelopathy in Salvador (Northeastern Brazil): a case-control study. Arq Neuropsiquiatr 1993, 51:447-451.

[8] 8. Mattos K, Queiroz C, Peçanha-Martins AC, Publio L, Melo A. Lymphocyte alveolitis in HAM/TSP patients. Arq Neuropsiquiatr 1993, 51:134-136.

[9] 9. Melo A, Gomes I, Mattos K. Mielopatias por HTLV-I na cidade de Salvador, Bahia. Arq Neuropsiquiatr 1994, 52:320-325.

[10] 10. Mita S, Sugimoto M, Nakamura M, Murakami T, Tokunaga M, Uyama E, Araki S. Increased human T-lymphotropic virus type-I (HTLV-I) proviral DNA in peripheral blood mononuclear cells and bronchoalveolar lavage cells from Japanese patients with HTLV-I associated myelopathy. Am J Trop Med Hyg 1993, 48:170-177.

[11] 11. Moreira ED Jr, Ribeiro TT, Swanson P, Sampaio C, Melo A, Brites C, Badaró R, Toedter G, Lee H, Harrington W Jr. Seroepidemiology of human T-cell lymphotropic virus type I/II in Northeastern Brazil. J AIDS 1993, 6: 959-963.

[12] 12. Osame M, Igata A, Matsumoto M, Kohka M, Usuku K, Izumo S. HTLV-I associated myelopathy (HAM): treatment trial, retrospective survey and clinical and laboratory findings. Hematol Rev 1990, 3:271-284.

[13] 13. Osame M, McArthur JC. Neurologic manifestations of infection with human T-cell lymphotropic virus type I. In Asbury AK, McKhann GM, McDonald Wl.(eds). Disease of the nervous systemxlinical neurobiology Philadelphia Saunders,1992 p 1331-1339.

[14] 14. Sugimoto M, NakashimaH, Kawano O, Ando M, Araki S. Bronchoalveolar T-lymphocytosis in HTLV-I associated myelopathy. Chest 1989, 95:708.

[15] 15. Sugimoto M, Imamura F, Matsumoto M, Sonoda E, Cho I, Ando M. Pulmonary involvement in patients with human T-lymphotropic virus type I-associated myelopathy: the presence of specific IgA antibody in bronchoalveolar lavage fluid. Am J Trop Med Hyg 1993, 48:803-811.