HTLV-I associated myelopathy in patients from Brazil and Iran: neurological manifestations and cerebrospinal fluid findings

Mielopatia associada a HTLV-I em pacientes do Brasil e do Irã: manifestações neurológicas e achados no líquido cefalorraquidiano

Abstracts

We analysed sera and cerebrospinal fluid (CSF) of 20 cases of human T-cell lymphotropic virus type (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) from Brazil and Iran and as controls, 16 Brazilian HTLVI seronegative individuals afflicted with other neurological diseases. It was observed in the HAM/TSP patients that: 1) all had an inflammatory reaction within the central nervous system (CNS); 2) 95% (19/20) showed oligoclonal bands reflecting intrathecal IgG synthesis; 3) 85% (17/20) presented a local synthesis of HTLVI antibodies; 4) 35% (7/20) had a measurable immunoglobulin (Ig) synthesis within the CNS. The CSF parameters of the HAM/TSP were compared with the clinical data (age at onset, duration of disease and disability level). Our data prove that CSF analysis is important for the diagnosis of HAM/TSP. There is no association between the severity of the disease and CSF findings.

HTLV-I; HAM; cerebrospinal fluid; multiple sclerosis


Foram analisadas amostras de líquido cefalorraquidiano (LCR) e plasma de 20 pacientes com mielopatia associada ao HTLV-I (HAM/TSP) provenientes do Brasil e Irã e como controle, 16 de indivíduos brasileiros soronegativos para HTLV-I acometidos por outras doenças neurológicas (esclerose múltipla, epilepsia idiopática e mielopatia de etiologia desconhecida). Observou-se no grupo de pacientes com HAM/TSP: 1) reação inflamatória no SNC em todos os casos; 2) 95% (19/20) mostravam bandas oligoclonais refletindo síntese intratecal de IgG no SNC; 3)85% (7/20) apresentavam síntese local de anticorpos para HTLV-I; 4)35% (tinham síntese mensurável de imunoglobulinas no SNC. Os parâmetros do LCR dos pacientes com HAM/TSP foram comparados aos dados clínicos (idade de início, duração da doença e grau de incapacidade). Os dados apresentados neste estudo indicam a importância da analise do LCR para diagnóstico de HAM/TSP. Entretanto nenhuma associação entre a gravidade da doença e os achados do LCR foi demonstrada.

HTLV-I; mielopatia; HAM; líquido cefalorraquidiano; esclerose múltipla


HTLV-I associated myelopathy in patients from Brazil and Iran: neurological manifestations and cerebrospinal fluid findings

Mielopatia associada a HTLV-I em pacientes do Brasil e do Irã: manifestações neurológicas e achados no líquido cefalorraquidiano

Marzia Puccioni-SohlerI, II; Bernid KitzeI; Klaus FelgenhauerI

IKlinik und Poliklinik für Neurologie der Georg-August-Universitát, Göttingen, Germany

IIServiço de Neurologia do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro (HUCFF/ UFRJ), CNPq/CAPES, Brasil, DAAD

SUMMARY

We analysed sera and cerebrospinal fluid (CSF) of 20 cases of human T-cell lymphotropic virus type (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) from Brazil and Iran and as controls, 16 Brazilian HTLVI seronegative individuals afflicted with other neurological diseases. It was observed in the HAM/TSP patients that: 1) all had an inflammatory reaction within the central nervous system (CNS); 2) 95% (19/20) showed oligoclonal bands reflecting intrathecal IgG synthesis; 3) 85% (17/20) presented a local synthesis of HTLVI antibodies; 4) 35% (7/20) had a measurable immunoglobulin (Ig) synthesis within the CNS. The CSF parameters of the HAM/TSP were compared with the clinical data (age at onset, duration of disease and disability level). Our data prove that CSF analysis is important for the diagnosis of HAM/TSP. There is no association between the severity of the disease and CSF findings.

Key words:HTLV-I, HAM/TSP, cerebrospinal fluid, multiple sclerosis.

RESUMO

Foram analisadas amostras de líquido cefalorraquidiano (LCR) e plasma de 20 pacientes com mielopatia associada ao HTLV-I (HAM/TSP) provenientes do Brasil e Irã e como controle, 16 de indivíduos brasileiros soronegativos para HTLV-I acometidos por outras doenças neurológicas (esclerose múltipla, epilepsia idiopática e mielopatia de etiologia desconhecida). Observou-se no grupo de pacientes com HAM/TSP: 1) reação inflamatória no SNC em todos os casos; 2) 95% (19/20) mostravam bandas oligoclonais refletindo síntese intratecal de IgG no SNC; 3)85% (7/20) apresentavam síntese local de anticorpos para HTLV-I; 4)35% (tinham síntese mensurável de imunoglobulinas no SNC. Os parâmetros do LCR dos pacientes com HAM/TSP foram comparados aos dados clínicos (idade de início, duração da doença e grau de incapacidade). Os dados apresentados neste estudo indicam a importância da analise do LCR para diagnóstico de HAM/TSP. Entretanto nenhuma associação entre a gravidade da doença e os achados do LCR foi demonstrada.

Palavras-chave: HTLV-I, mielopatia, HAM/TSP, líquido cefalorraquidiano, esclerose múltipla.

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Acknowledgement

We thank Prof. Dr. H.O. Reiber for his helpfull support at the Neurochemistry Labor von der Klinik und Poliklinik für Neurologie der Georg-August-Universitãt, Gõttingen, Germany.

Aceite: 4-novembro-1994.

Dra. Marzia Puccioni-Sohler - R. Francisco Sá, 26/1201 - 22080-010 Rio de Janeiro RJ - Brasil. Fax: (55)(21) 5211175.

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Publication Dates

  • Publication in this collection
    20 Jan 2011
  • Date of issue
    June 1995
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