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.
Adv Rheumatol. 2022 Aug 9;62(1):31. doi: 10.1186/s42358-022-00259-y.
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.
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.
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.
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.
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。
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。
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。
HTLV-1 相关关节病的临床特征为对称性多关节痛，主要的放射学发现是存在附着点炎而无骨赘和关节间隙变窄。
