Erschienen in:
01.02.2015 | Central Nervous System Infections (J Lyons, Section Editor)
Update on Neurological Manifestations of HTLV-1 Infection
verfasst von:
Abelardo Q-C Araujo
Erschienen in:
Current Infectious Disease Reports
|
Ausgabe 2/2015
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Abstract
The human T cell lymphotropic virus type 1 (HTLV-1) is a retrovirus that infects 10–20 million persons around the world. Initially associated with the hematological malignancy adult T cell leukemia/lymphoma (ATLL), HTLV-1 is also the cause of a chronic progressive myelopathy named “HTLV-1-associated myelopathy/tropical spastic paraparesis” (HAM/TSP). HAM/TSP arises as the tip of the iceberg of an assortment of neurological syndromes triggered by the virus such as inflammatory myopathies, polyneuropathies, amyotrophic lateral sclerosis (ALS)-like syndromes, dysautonomia, and cognitive impairment. HAM/TSP typifies a chronic progressive spastic paraparesis with neurogenic bladder and minimal sensory signs. The neuropathology of HAM/TSP is concentrated in the thoracic spinal cord and is typically biphasic. Initially, there is a perivascular lymphocytic cuffing and mild parenchymal mononuclear infiltrates. Subsequently, this is replaced by gliosis and scarring. The neuropathogenesis of HTLV-1 is still partially understood. At present, the therapy of HAM/TSP remains basically symptomatic.