人类嗜T淋巴细胞病毒1型相关脊髓病/热带痉挛性截瘫（HAM/TSP）诊断中的困难
Difficulties in HAM/TSP diagnosis.
作者信息
Slater Carla Maria Sena Andrade, Ribeiro Luiz Claudio Pereira, Puccioni-Sohler Marzia
机构信息
Neuroinfection Clinic, Hospital Universitário Gaffrée e Guinle (HUGG), Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro RJ, Brazil.
出版信息
Arq Neuropsiquiatr. 2012 Sep;70(9):686-90. doi: 10.1590/s0004-282x2012000900007.
UNLABELLED
The World Health Organization recommends the use of Osame's criterion (1990) for the diagnosis of HTLV-I-associated myelopathy (HAM/TSP). In 2006, a group of neurologists developed a Brazilian criterion that can diagnose HAM/TSP from its onset.
OBJECTIVE
It was to test the agreement between both criteria.
METHODS
The study included evaluation of clinical and laboratory findings of 35 patients. The ELISA, Western blot and/or polymerase chain reaction was used to search for anti-HTLV-I antibodies. The analysis of agreement was based on the calculation of Kappa.
RESULTS
Concordance of 100% (Kappa=1) occurred in cases of "defined" HAM/TSP, but not in patients with "probable" diagnosis.
CONCLUSION
The Brazilian criteria was as effective as Osame's criteria for the diagnosis of "defined" HAM/TSP. However, both require more specific biological markers in cerebrospinal fluid for the laboratory diagnosis of probable cases.
未标注
世界卫生组织推荐使用大见（Osame）标准（1990年）来诊断人类嗜T淋巴细胞病毒I型相关脊髓病（HAM/TSP）。2006年，一组神经科医生制定了一项巴西标准，该标准能够从疾病发作时诊断HAM/TSP。
目的
检验这两种标准之间的一致性。
方法
该研究纳入了对35例患者的临床和实验室检查结果的评估。采用酶联免疫吸附测定（ELISA）、蛋白质印迹法和/或聚合酶链反应来检测抗人类嗜T淋巴细胞病毒I型抗体。一致性分析基于卡帕（Kappa）值的计算。
结果
在“明确的”HAM/TSP病例中一致性为100%（Kappa = 1），但在“可能的”诊断患者中并非如此。
结论
巴西标准在诊断“明确的”HAM/TSP方面与大见标准同样有效。然而，对于可能病例的实验室诊断，两者都需要脑脊液中更具特异性的生物标志物。
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