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Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis
Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350296/ https://www.ncbi.nlm.nih.gov/pubmed/32517313 http://dx.doi.org/10.3390/pathogens9060450 |
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author | Schwalb, Alvaro Pérez-Muto, Valeria Cachay, Rodrigo Tipismana, Martín Álvarez, Carolina Mejía, Fernando González-Lagos, Elsa Gotuzzo, Eduardo |
author_facet | Schwalb, Alvaro Pérez-Muto, Valeria Cachay, Rodrigo Tipismana, Martín Álvarez, Carolina Mejía, Fernando González-Lagos, Elsa Gotuzzo, Eduardo |
author_sort | Schwalb, Alvaro |
collection | PubMed |
description | Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity. |
format | Online Article Text |
id | pubmed-7350296 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73502962020-07-15 Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis Schwalb, Alvaro Pérez-Muto, Valeria Cachay, Rodrigo Tipismana, Martín Álvarez, Carolina Mejía, Fernando González-Lagos, Elsa Gotuzzo, Eduardo Pathogens Article Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity. MDPI 2020-06-07 /pmc/articles/PMC7350296/ /pubmed/32517313 http://dx.doi.org/10.3390/pathogens9060450 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Schwalb, Alvaro Pérez-Muto, Valeria Cachay, Rodrigo Tipismana, Martín Álvarez, Carolina Mejía, Fernando González-Lagos, Elsa Gotuzzo, Eduardo Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title | Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title_full | Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title_fullStr | Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title_full_unstemmed | Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title_short | Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis |
title_sort | early-onset htlv-1-associated myelopathy/tropical spastic paraparesis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350296/ https://www.ncbi.nlm.nih.gov/pubmed/32517313 http://dx.doi.org/10.3390/pathogens9060450 |
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