HTLV-I ASSOCIATED MYELOPATHY, A NEW CLINICAL ENTITY
HTLV-I ASSOCIATED MYELOPATHY, A NEW CLINICAL ENTITY
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DOI：
10.1016/s0140-6736(86)91298-5
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发表时间：
1986-05
期刊：
影响因子：
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通讯作者：
M. Osame;K. Usuku;S. Izumo;N. Ijichi;H. Amitani;A. Igata;M. Matsumoto;M. Tara
中科院分区：
文献类型：
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作者：
M. Osame;K. Usuku;S. Izumo;N. Ijichi;H. Amitani;A. Igata;M. Matsumoto;M. Tara
记者对Gessainet等人的报告发表评论(上图)。他们还报告了6名患者(4名女性，2名男性)，年龄在25-58岁之间，患有缓慢进行性痉挛瘫痪。这些病例出现在日本鹿儿岛县，那里的抗HTLV-I流行率约为16%。经乳胶凝集试验，6株血清(512-8192)和脑脊液(-512)具有很高的抗HTLV-I滴度。在78例神经对照患者中，12例血清滴度为16-2048。只有一个对照组脑脊液中有抗HTLV-I抗体。截瘫患者脑脊液免疫印迹显示两条清晰条带(p24和p32)。他们的白细胞计数是正常的，尽管在一些患者中可以看到与ATIL相关的淋巴细胞出现。6例中有4例在步态、感觉和括约肌控制方面得到改善。随后，对以前未确诊的患者进行的脑脊液免疫印迹抗HTLV-I检测又发现了7例。作者建议将这种痉挛截瘫称为HTLV-I型相关性脊髓病(HAM)。在随后的一封信(同上，II，104-105)中，他们报告了另外17例，也住在鹿儿岛县。在23例患者中，有9例(39%)在出现症状之前曾输血，这一比例远远高于3个对照组：成人T细胞白血病/淋巴瘤患者、内科住院患者和医院工作人员。Newline˜P.Mormer
The correspondents comment on the reports of Gessainet al.(above). They also report 6 patients (4 women, 2 men) aged 25-58 years, with slowly progressive spastic paraparesis. These cases were seen in the Kagoshima prefecture of Japan, where the prevalence of anti-HTLV-I is about 16%. The 6 had very high anti-HTLV-I titres by latex agglutination in serum (512-8192) and in CSF (64-512). Out of 78 neurological control patients 12 were seropositive (serum titre 16-2048). Only one control had anti-HTLV-I in CSF. In the paraparetic patients Western blot of CSF showed 2 clear bands (p24 and p32). Their white blood cell counts were normal though ATLL-associated lymphocyte appearances were seen in some. Four of 6 were treated with prednisolone in a tapering dose with improvement in gait, sensation and sphincter control. Subsequently Western blot anti-HTLV-I testing of the CSF of previously undiagnosed patients has revealed 7 more cases. The authors suggest that this spastic paraparesis be called HTLV-I-associated myelopathy (HAM).In a subsequent letter (ibid., ii,104-105) they report a further 17 cases, who also lived in Kagoshima prefecture. Nine (39%) of the 23 cases had had a blood transfusion before onset of symptoms, a much higher frequency than in 3 control groups; patients with adult T-cell leukaemia/lymphoma, internal medicine inpatients, and hospital staff.newline˜P. Mortimer