人类 T 淋巴细胞病毒 1 型（HTLV-1）感染个体的关节痛的影像学特征。

Radiographic aspects in individuals infected by human T-lymphotropic virus type 1 (HTLV-1) with joint pain.

机构信息

Immunology Service of HUPES-UFBA, Post-Graduation Program in Health Science of the Federal University of Bahia, Praça Ramos de Queirós, s/n - Largo do Terreiro de Jesus, Salvador, Bahia, CEP 40026-010, Brazil.

Division of Immunology, University Hospital Professor Edgard Santos (HUPES), Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.

出版信息

Adv Rheumatol. 2022 Aug 9;62(1):31. doi: 10.1186/s42358-022-00259-y.

DOI:10.1186/s42358-022-00259-y

PMID:35945643

Abstract

BACKGROUND

Joint pain in the absence or with little synovitis is observed in a large percentage of HTLV-1 infected subjects. As the virus infect CD4 + and CD8 + positive, macrophages and B cells an exaggerated production of pro-inflammatory cytokines is detected in these patients. However, the possible association of HTLV-1 infection with autoimmune diseases has not been documented definitively and the clinical characteristics of HTLV-1 associated arthropathy has not been defined. The objective this study is to describe clinic and radiographic features in HTLV-1-infected individuals with complaints of joint pain.

METHODS

Cross-sectional study enrolling HTLV-1-infected individuals with chronic joint pain, aged up to 75 years, both genders and seronegative controls with osteoarthritis. All participants underwent conventional radiography of the hips, knees and ankles.

RESULTS

Eighty-one HTLV-1 infected patients and 30 subjects with osteoarthritis participated in the study. Polyarticular and symmetrical arthritis prevailed in the HTLV-1 positive group (54%), while oligoarticular and asymmetrical (44%) were more common in controls (p < 0.05). The frequency of enthesophytes (90%) in HTLV-1-infected patients was greater than in the control group (73%) (p < 0.05). Radiographic features were similar in HTLV-1 carriers and in patients with probable or definite HTLV-1 associated myelopathy. The presence of enthesophytes in the absence of joint space reduction or osteophytes was only observed in HTLV-1-infected individuals (p < 0.001). Magnetic resonance imaging of the ankles of five HTLV-1-infected patients and five controls demonstrated a higher frequency of enthesitis, bursitis and osteitis in the HTLV-1 infected group.

CONCLUSION

HTLV-1-associated arthropathy is clinically characterized by symmetrical polyarthralgia and the main radiological finding is the presence of enthesophytes in the absence of osteophytes and joint space narrowing.

摘要

背景

在很大比例的 HTLV-1 感染患者中，观察到关节疼痛而无或仅有少量滑膜炎。由于病毒感染 CD4+和 CD8+阳性细胞、巨噬细胞和 B 细胞，这些患者中可检测到促炎细胞因子的过度产生。然而，HTLV-1 感染与自身免疫性疾病的可能关联尚未得到明确证实，HTLV-1 相关关节病的临床特征也尚未确定。本研究旨在描述有慢性关节痛主诉的 HTLV-1 感染个体的临床和影像学特征。

方法

这项横断面研究纳入了慢性关节痛的 HTLV-1 感染个体，年龄在 75 岁以下，包括男女两性和血清学阴性的骨关节炎对照者。所有参与者均接受了髋关节、膝关节和踝关节的常规 X 线摄影。

结果

81 例 HTLV-1 感染患者和 30 例骨关节炎对照者参与了这项研究。多关节和对称性关节炎在 HTLV-1 阳性组中更为常见（54%），而寡关节和不对称性关节炎（44%）在对照组中更为常见（p<0.05）。在 HTLV-1 感染患者中，附着点炎（90%）的发生率高于对照组（73%）（p<0.05）。在 HTLV-1 携带者和可能或明确的 HTLV-1 相关脊髓病患者中，放射学特征相似。只有在 HTLV-1 感染个体中才观察到存在附着点炎而无关节间隙变窄或骨赘（p<0.001）。对 5 例 HTLV-1 感染患者和 5 例对照者的踝关节磁共振成像显示，在 HTLV-1 感染组中，附着点炎、滑囊炎和骨炎的发生率更高。