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1996-01-30
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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).