Tannus Matheus, Tanajura Davi, Sundberg Michael A, Oliveira Paulo, Castro Neviton, Santos André Muniz
Serviço de Imunologia, Hospital Universitário Proffessor Edgard Santos, 5 Andar, Rua João das Botas S/N, Canela, Salvador CEP 40110-160, BA, Brazil.
Case Rep Med. 2011;2011:289389. doi: 10.1155/2011/289389. Epub 2011 Apr 13.
The HTLV-1 virus is a known agent involved in the development of HAM/TSP. Past studies have typically observed patients with autonomic dysfunction consisting of detrusor overactivity and detrusor-sphincter dyssynergia, with the occasional observation of underactive detrusor or detrusor arreflexia. However, studies have not yet evaluated the progression of neurogenic bladder over time. In this paper, we describe a HAM/TSP patient with the initial development of overactive detrusor, and subsequent development of detrusor arreflexia. Given a paucity of studies characterizing the effects of HTLV-1 on the autonomic nervous system, particularly aspects controlling continence, this patient's clinical course may represent one type of end point for patients with HAM/TSP and neurogenic bladder. Further cohort or case-series studies, with particular emphasis on the progression of neurogenic bladder, are needed to evaluate the significance of this described case in relation to typical disease progression patterns.
人类嗜T细胞病毒1型（HTLV-1）是一种已知与热带痉挛性截瘫/脊髓病（HAM/TSP）发病有关的病原体。过去的研究通常观察到患者存在自主神经功能障碍，包括逼尿肌过度活动和逼尿肌-括约肌协同失调，偶尔也会观察到逼尿肌活动不足或逼尿肌无反射。然而，尚未有研究评估神经源性膀胱随时间的进展情况。在本文中，我们描述了一名HAM/TSP患者，最初出现逼尿肌过度活动，随后发展为逼尿肌无反射。鉴于关于HTLV-1对自主神经系统影响的研究较少，特别是对控制排尿方面的影响，该患者的临床病程可能代表了HAM/TSP和神经源性膀胱患者的一种终点类型。需要进一步开展队列研究或病例系列研究，尤其着重于神经源性膀胱的进展情况，以评估该病例描述相对于典型疾病进展模式的意义。
