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干扰素β-1a治疗人类嗜T淋巴细胞病毒1型相关脊髓病/热带痉挛性截瘫:一例报告

Interferon beta-1a treatment in HTLV-1-associated myelopathy/tropical spastic paraparesis: a case report.

作者信息

Viana Graça Maria de Castro, Silva Marcos Antonio Custódio Neto da, Souza Victor Lima, Lopes Natália Barbosa da Silva, Silva Diego Luz Felipe da, Nascimento Maria do Desterro Soares Brandão

机构信息

Departamento de Patologia, Universidade Federal do Maranhão, São Luis, MA, Brazil.

Curso de Medicina, Universidade Federal do Maranhão, São Luis, MA, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2014 Sep-Oct;56(5):443-5. doi: 10.1590/s0036-46652014000500013.

Abstract

Here a young patient (< 21 years of age) with a history of infective dermatitis is described. The patient was diagnosed with myelopathy associated with HTLV-1/tropical spastic paraparesis and treated with interferon beta-1a. The disease was clinically established as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and laboratory tests confirmed the presence of antibodies to HTLV-1 in the cerebrospinal fluid (CSF). Mumps, cytomegalovirus, Epstein-Barr virus, schistosomiasis, herpes virus 1 and 2, rubella, measles, varicella-zoster toxoplasmosis, hepatitis, HIV, and syphilis were excluded by serology. The patient was diagnosed with neurogenic bladder and presented with nocturia, urinary urgency, paresthesia of the lower left limb, a marked reduction of muscle strength in the lower limbs, and a slight reduction in upper limb strength. During the fourth week of treatment with interferon beta-1a, urinary urgency and paresthesia disappeared and clinical motor skills improved.

摘要

本文描述了一名患有感染性皮炎病史的年轻患者(年龄<21岁)。该患者被诊断为与人类嗜T淋巴细胞病毒1型/热带痉挛性截瘫相关的脊髓病,并接受了β-1a干扰素治疗。该疾病在临床上被确诊为人类嗜T淋巴细胞病毒1型相关脊髓病/热带痉挛性截瘫(HAM/TSP),实验室检查证实脑脊液(CSF)中存在抗人类嗜T淋巴细胞病毒1型抗体。通过血清学检查排除了腮腺炎、巨细胞病毒、EB病毒、血吸虫病、单纯疱疹病毒1型和2型、风疹、麻疹、水痘-带状疱疹、弓形虫病、肝炎、HIV和梅毒。该患者被诊断为神经源性膀胱,表现为夜尿症、尿急、左下肢感觉异常、下肢肌肉力量明显减弱以及上肢力量略有下降。在使用β-1a干扰素治疗的第四周,尿急和感觉异常消失,临床运动技能有所改善。

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本文引用的文献

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Clinical and immunological features of patients with atopy and concomitant HTLV-1 infection.
Braz J Med Biol Res. 2010 Dec;43(12):1167-72. doi: 10.1590/s0100-879x2010007500138. Epub 2010 Dec 3.
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Frequency of mental disturbances in HTLV-1 patients in the state of Bahia, Brazil.
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[Human T-cell lymphotropic virus type 1(HTLV-1)-associated myelopathy].
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