Document 0665
 DOCN  M9610665
 TI    HTLV-I positive progressive spastic paraparesis (TSP) associated with a
       lymphoid disorder in three Chilean patients.
 DT    9601
 AU    Cartier L; Castillo JL; Cabrera ME; Araya F; Matutes E; Ford AM; Greaves
       MF; Department of Neurology, Faculty of Medicine, University of; Chile,
       Santiago.
 SO    Leuk Lymphoma. 1995 May;17(5-6):459-64. Unique Identifier : AIDSLINE
       MED/96037825
 AB    We describe the clinical and laboratory features in three Caucasian
       Chilean patients with tropical spastic paraparesis (TSP) associated
       with/or preceded by a lymphoproliferative disorder involving cutaneous
       lesions and localised lymphadenopathy. The neurological symptoms and
       signs were characteristic of TSP and CSF examination revealed the
       presence of oligoclonal bands. All three patients had a moderate
       leucocytosis (10-14 x 10(9)/l) with eosinophilia and a minority (2-4%)
       of circulating atypical polylobed or ATLL-like lymphocytes. Lymph node
       histology showed a diffuse pattern of infiltration (1 case) and marked
       expansion of the paracortical zone with convoluted lymphocytes and
       immunoblasts (2 cases). Skin biopsy demonstrated a dermal lymphoid
       infiltration with epidermotropism. Antibodies to HTLV-I were detected in
       the serum and CSF in the three patients and Southern blot analysis of
       peripheral blood mononuclear cells showed a monoclonal integration of
       HTLV-I proviral DNA in one case whereas in the two others the pattern
       was indicative of low level polyclonal integration. All three patients
       were treated with prednisolone and one with PUVA with transient partial
       response on the skin and neurological manifestations. Two patients died
       months to 5 years from presentation and the other is alive 12 years from
       diagnosis with active neurological and skin disease. The simultaneous
       occurrence of HTLV-I associated TSP with smouldering ATLL and a
       cutaneous ATLL or pre-leukaemic form is discussed.
 DE    Adult  Antibodies, Viral/BLOOD/CEREBROSPINAL FLUID/IMMUNOLOGY  Antigens,
       CD/IMMUNOLOGY  Blotting, Southern  Case Report  Dermatitis,
       Exfoliative/COMPLICATIONS  Female  Human  Leukemia,
       T-Cell/*COMPLICATIONS/PATHOLOGY/VIROLOGY  Male  Middle Age  Paraparesis,
       Tropical Spastic/*COMPLICATIONS/DRUG THERAPY/  PATHOLOGY/VIROLOGY
       Prednisolone/THERAPEUTIC USE  Proviruses/ISOLATION & PURIF  PUVA Therapy
       Skin/PATHOLOGY  Support, Non-U.S. Gov't
       T-Lymphocytes/IMMUNOLOGY/PATHOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).