Systemic diseases in patients with HTLV-1-associated uveitis.
Systemic diseases in patients with HTLV-1-associated uveitis.
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HTLV-1相关葡萄膜炎患者的全身性疾病。
DOI：
10.1136/bjophthalmol-2017-310658
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Sakamoto T
中科院分区：
文献类型：
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作者：
Nakao K;Abematsu N;Sakamoto T
背景人类T淋巴细胞病毒1型(HTLV-1)携带者可能发生严重的全身性疾病，如成人T细胞白血病(ATL)或HTLV-1相关性脊髓病/热带痉挛麻痹(HAM/TSP)。本研究旨在调查HTLV-1携带者发生HTLV-1相关性葡萄膜炎(HAU)的全身性疾病。方法通过对200例HAU患者的病历回顾和邮寄调查结果进行分析。结果HTLV-1携带者平均发病年龄49岁，发病总人年1627人。有两例ATL。其中一例在HAU发病时被诊断为阴燃ATL，另一例在HAU发病4年后发展为急性型ATL。HAM/TSP 26例，其中HAM/TSP首发13例，HAU首发11例。HAM/TSP和HAU的发病间隔为6个月~6年，HAM/TSP和HAU的发病时间间隔无显著差异。甲状腺功能亢进症45例，均在发病前。甲氨咪唑治疗后发病，2例甲硫唑治疗后复发。结论HTLV-1 HAU携带者较普通携带者更易发生HAM/TSP。接受甲亢治疗的HTLV-1携带者可能容易发生HAU。
BackgroundHuman T-lymphotropic virus type 1 (HTLV-1) carriers may develop severe systemic diseases, such as adult T cell leukaemia (ATL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This study aims to investigate systemic diseases of HTLV-1 carriers who had developed HTLV-1-associated uveitis (HAU).MethodsWe investigated the occurrence of systemic diseases in 200 patients with HAU by performing a retrospective investigation of their medical records and examining the results of a postal survey.ResultsThe mean age of HAU onset was 49 years, and the total person-years from HAU onset was 1627. There were two cases of ATL. Of these, one was diagnosed with smouldering ATL at the time of HAU onset and the other developed acute-type ATL 4 years after HAU onset. There were 26 cases of HAM/TSP; of these, HAM/TSP occurred first in 13 cases and HAU occurred first in 11 cases. The interval between the onset of HAM/TSP and HAU ranged from 6 months to 6 years, with no significant difference observed based on whether HAM/TSP or HAU occurred first. Hyperthyroidism was noted in 45 cases and preceded onset in all cases. HAU onset occurred after starting thiamazole treatment, and in two cases HAU recurred each time thiamazole treatment was restarted.ConclusionHTLV-1 carriers with HAU may develop HAM/TSP more frequently than general carriers. HTLV-1 carriers undergoing treatment for hyperthyroidism may be prone to developing HAU.