Infective Dermatitis and Human T Cell Lymphotropic Virus Type 1–Associated Myelopathy/Tropical Spastic Paraparesis in Childhood and Adolescence

• Published in: Clinical infectious diseases Vol. 41; no. 4; pp. 535 - 541
• Main Authors: Primo, Janeusa Rita L., Brites, Carlos, de Oliveira, Maria de Fátima S. P., Moreno-Carvalho, Otávio, Machado, Marcos, Bittencourt, Achilùa L.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.08.2005; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Allergic diseases; Antibodies; Antibodies, Viral - blood; Antibodies, Viral - cerebrospinal fluid; Biological and medical sciences; Cerebrospinal Fluid - virology; Child; Children; Children & youth; Cluster Analysis; Dermatitis; Dermatitis - genetics; Dermatitis - virology; Dermatology; Family; Female; Genetics; HIV/AIDS; HTLV-I Infections - complications; HTLV-I Infections - diagnosis; HTLV-I Infections - genetics; Human T lymphotropic virus 1; Human T-lymphotropic virus 1 - immunology; Human T-lymphotropic virus 1 - isolation & purification; Humans; Immunopathology; Infections; Male; Medical sciences; Mothers; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurologic Examination; Neurology; Paraparesis, Tropical Spastic - complications; Paraparesis, Tropical Spastic - genetics; Siblings; Skin allergic diseases. Stinging insect allergies; Skin Diseases, Viral - complications; Skin Diseases, Viral - genetics; Skin involvement in other diseases. Miscellaneous. General aspects; Spinal cord diseases; T lymphocytes; Teenagers; Viruses; World; Human; Allergy; Immunopathology; Skin disease; Nervous system diseases; Deltaretrovirus; Motor system disorder; Retroviridae; Nervous system; Paraparesia; Dermatitis; Genetic disease; Virus; Myelopathy; Chronic; Paresis; Adolescent; Eczema; Neurological disorder; HTLV-I virus; Child
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/432058

Background. Human T cell lymphotropic virus type 1 (HTLV-1)–associated infective dermatitis (IDH) is a chronic and recurrent eczema occurring during childhood and adolescence. HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic myelopathy of adulthood, presenting with slowly progressive spastic paraparesis and sphincter dysfunction with mild sensory involvement. There are few reports describing an association between IDH and HAM/TSP. The objective of this study was to evaluate the occurrence of HAM/TSP in patients with IDH and in seropositive members of their families and to determine the blood levels of antibodies against HTLV-1 in patients with HAM/TSP. Methods. Twenty patients with IDH and their seropositive mothers and siblings underwent clinical, neurological, and laboratory evaluations. The diagnosis of HAM/TSP was made in accordance with the World Health Organization criteria. Results. Nine individuals had HAM/TSP (6 of the patients with IDH, 2 mothers, and 1 seropositive brother). In 3 families, >1 individual had HAM/TSP. The serum antibody titers of the patients with HAM/TSP varied from 1 : 3.125 to 1 : 78.125. Conclusions. A strong association was observed between IDH and HAM/TSP. The familial clustering of both diseases suggests a genetic background. Serological screening for HTLV-1 in children with symptoms of myelopathy is essential in areas where HTLV-1 is endemic.