Dixon P S, Bodner A J, Okihiro M, Milbourne A, Diwan A, Nakamura J M
Department of Medicine, Miriam Hospital, Providence, Rhode Island.
West J Med. 1990 Mar;152(3):261-7.
Tropical spastic paraparesis or human T-lymphotropic virus type I (HTLV-I)-associated myelopathy is a degenerative encephalomyelopathy with pyramidal tract dysfunction affecting the lower extremities. It is associated with HTLV-I infection and found primarily in the Caribbean region and in southwestern Japan. Five cases of tropical spastic paraparesis (or HTLV-I-associated myelopathy) in Hawaii are reported. All five patients were born in Hawaii; four are women. Each of the patients has parents who were from HTLV-I-endemic areas of Japan. Two of these patients had serum antibodies to HTLV-I. Five of six of the spouses and children of the seropositive patients were also seropositive. Viral cultures of lymphocytes from both seropositive patients and two of the three seropositive children were positive for HTLV-I. None of the five patients had a history of antecedent blood transfusion, multiple sexual partners, or intravenous drug use. There is no evidence of adult T-cell leukemia or lymphoma in any of the patients or their families. Given the increasing seroprevalence of HTLV-I in the United States, clinicians need to be alert to new cases of this disorder.
热带痉挛性截瘫或人类嗜T淋巴细胞病毒I型（HTLV-I）相关脊髓病是一种伴有锥体束功能障碍、影响下肢的退行性脑脊髓病。它与HTLV-I感染相关，主要见于加勒比地区和日本西南部。本文报告了夏威夷的5例热带痉挛性截瘫（或HTLV-I相关脊髓病）病例。所有5例患者均出生于夏威夷；4例为女性。每位患者的父母均来自日本HTLV-I流行地区。其中2例患者血清中存在HTLV-I抗体。血清阳性患者的配偶和子女中，6人中有5人血清也呈阳性。血清阳性患者及3名血清阳性儿童中的2名儿童的淋巴细胞病毒培养显示HTLV-I呈阳性。5例患者均无输血史、多个性伴侣或静脉吸毒史。所有患者及其家族中均无成人T细胞白血病或淋巴瘤的证据。鉴于美国HTLV-I血清阳性率不断上升，临床医生需要警惕该疾病的新发病例。
