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病例报告:儿童1型人类嗜T淋巴细胞病毒相关感染性皮炎准确诊断与监测的相关性

Case Report: Relevance of an Accurate Diagnosis and Monitoring of Infective Dermatitis Associated With Human T-Lymphotropic Virus Type 1 in Childhood.

作者信息

Benencio Paula, Ducasa Nicolás, Arruvito Lourdes, Irurzun Inés, Praino Laura, Lamberti Magdalena, Beraza María, Berini Carolina, Biglione Mirna

机构信息

Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), CONICET- Universidad de Buenos Aires, Buenos Aires, Argentina.

Unidad de Dermatología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.

出版信息

Front Med (Lausanne). 2021 Nov 10;8:758352. doi: 10.3389/fmed.2021.758352. eCollection 2021.

Abstract

Human T-lymphotropic virus type 1 (HTLV-1) is a neglected retrovirus distributed worldwide and the ethiological agent of several pathologies, such as adult T-cell leukemia/lymphoma (ATLL), a chronic myelopathy known as HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH). HTLV-1 presents tropism for CD4 T cells and induces deregulation of the cytokine profile. IDH is a severe, chronic superinfected eczema generally associated with and/or infection that responds partially to antibiotic therapy but prompt recurrence develops upon treatment withdrawal. IDH could be a risk factor for progression toward both HAM/TSP and ATLL and, similarly to other diseases associated with HTLV-1, it is sub-diagnosed particularly in non-endemic areas. Here, we present a case of IDH in a young boy living in Buenos Aires with symptoms since 2010, at the age of 5. HTLV-1 infection was suspected and confirmed in 2016. The patient exhibited chronic dermatosis with exudative eruption involving mainly the scalp, retroauricular regions, neck and abdomen. Clinical evaluations, routine laboratory tests, full blood count, and HTLV-1 diagnosis for this case are included.

摘要

人类嗜T淋巴细胞病毒1型(HTLV-1)是一种被忽视的逆转录病毒,在全球范围内广泛分布,是多种疾病的病原体,如成人T细胞白血病/淋巴瘤(ATLL)、一种称为HTLV-1相关脊髓病/热带痉挛性截瘫(HAM/TSP)的慢性脊髓病以及与HTLV-1相关的感染性皮炎(IDH)。HTLV-1具有对CD4 T细胞的嗜性,并诱导细胞因子谱的失调。IDH是一种严重的慢性重叠感染性湿疹,通常与 和/或 感染相关,对抗生素治疗有部分反应,但停药后会迅速复发。IDH可能是发展为HAM/TSP和ATLL的危险因素,与其他与HTLV-1相关的疾病类似,它在非流行地区尤其容易漏诊。在此,我们报告一例居住在布宜诺斯艾利斯的小男孩的IDH病例,该男孩自2010年5岁起出现症状。2016年怀疑并确诊为HTLV-1感染。患者表现为慢性皮肤病,伴有渗出性皮疹,主要累及头皮、耳后区域、颈部和腹部。本文包括该病例的临床评估、常规实验室检查、全血细胞计数以及HTLV-1诊断。 (注:原文中“ 和/或 ”部分内容缺失)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16f5/8660090/3635376ef1fb/fmed-08-758352-g0001.jpg

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