HTLV-1 anticorpos no soro e no liquido cefalorraqueano na paraparesis espástica tropical no Brasil

anp Arquivos de Neuro-Psiquiatria Arq. Neuro-Psiquiatr. 0004-282X 1678-4227 Academia Brasileira de Neurologia - ABNEURO São Paulo, SP, Brazil Foi pesquisada a presença de HTLV-l anticorpos no soro e no LCR de 150 pacientes com afeccões do sistema nervoso, particularmente mielopatias. Os pacientes foram considerados segundo três grupos, de acordo com a possível relação entre a doença e a presença de HTLV-l anticorpos: sem risco de relação (grupo controle); grupo de risco ocasional; grupo de risco possível. Este último abrange 56 pacientes com paraparesia ou paraplegia crural espástica de etiologia não esclarecida (PE). Foi utilizada para a pesquisa a técnica de aglutinação passiva de partículas para anti-ATLA anticorpo, sendo obtidos os seguintes resultados: não foram detectados HTLV-l anticorpos no grupo controle e foram detectados (soro e/ou LCR) em 16,5% dos pacientes do segundo grupo e em 55,4% daqueles do terceiro grupo. O quadro clínico dos pacientes com PE e HTLV-l anticorpos era compatível a paraparesia espática tropical (PET). Foi verificada diferença significativa quanto a dados do exame de LCR (citologia, concentração proteica e teor de globulinas gama) ao se compararem os pacientes com PET com HTLV-l anticorpos no LCR àqueles com PE em que tais anticorpos não foram detectados nem no soro e nem no LCR. Os resultados deste estudo confirmam a elevada incidência da PET no Brasil o ilustram a necessidade da pesquisa desses anticorpos também no LCR. HTLV-1 antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil HTLV-1 anticorpos no soro e no liquido cefalorraqueano na paraparesis espástica tropical no Brasil A. Spina-FrançaI; J. A. LivramentoII; L. R. MachadoII; H. R. GomesIII; L. S. ViannaIII; L. H. M. CastroIII; J. P. S. NobregaII; L. A. BaciheschiII IFull Professor - Neurology Research Center, Department of Neurology, São Paulo University Medical School IIAssistant Professor - Neurology Research Center, Department of Neurology, São Paulo University Medical School IIINeurologist Researcher - Neurology Research Center, Department of Neurology, São Paulo University Medical School SUMMARY HTLV-l antibodies were investigated in serum and in CSF of 150 patients with neurologic disorders mainly myelopathies. The patients were considered into three groups according to the possible relationship of their disease to the presence of HTLV-l antibodies: no relationship risk (control group), occasional risk group, and possible risk group. In this latter are 56 patients with crural spastic paraparesis or paraplegia of unknown etiology (SP). HTLV-l antibodies were tested by the passive particle-agglutination method for anti-ATLA antibody detection. The search was negative in all patients of the control group, and positive (serum and/or CSF) in 16.5% of the patients from the second group and in 55.4% of the SP patients group. Clinical patterns in SP cases with HTLV-l antibodies were those of tropical spastic paraparesis (TSP). CSF patterns considered (cytology, protein content and gamma-globulins rate) were different between TSP group with HTLV-l antibodies in CSF and SP group with no HTLV-l antibodies detection either in serum or in CSF. The difference was significant. Results of this investigation confirm the high incidence of TSP in Brazil, and bring additional indication for searching HTLV-l antibodies in the CSF. RESUMO Foi pesquisada a presença de HTLV-l anticorpos no soro e no LCR de 150 pacientes com afeccões do sistema nervoso, particularmente mielopatias. Os pacientes foram considerados segundo três grupos, de acordo com a possível relação entre a doença e a presença de HTLV-l anticorpos: sem risco de relação (grupo controle); grupo de risco ocasional; grupo de risco possível. Este último abrange 56 pacientes com paraparesia ou paraplegia crural espástica de etiologia não esclarecida (PE). Foi utilizada para a pesquisa a técnica de aglutinação passiva de partículas para anti-ATLA anticorpo, sendo obtidos os seguintes resultados: não foram detectados HTLV-l anticorpos no grupo controle e foram detectados (soro e/ou LCR) em 16,5% dos pacientes do segundo grupo e em 55,4% daqueles do terceiro grupo. O quadro clínico dos pacientes com PE e HTLV-l anticorpos era compatível a paraparesia espática tropical (PET). Foi verificada diferença significativa quanto a dados do exame de LCR (citologia, concentração proteica e teor de globulinas gama) ao se compararem os pacientes com PET com HTLV-l anticorpos no LCR àqueles com PE em que tais anticorpos não foram detectados nem no soro e nem no LCR. Os resultados deste estudo confirmam a elevada incidência da PET no Brasil o ilustram a necessidade da pesquisa desses anticorpos também no LCR. Texto completo disponível apenas em PDF. Full text available only in PDF format. Dr. A. SpinaFr-ança - Caixa Postal 5199 - 01051 São Paulo SP - Brasil. 1. Aboulafia DM, Saxton EM, Koga H, Diagne A, Rosenblatt JD - A patient with progressive myelopathy and antibodies to human T-cell leukemia virus type 1 and human immunodeficiency virus type 1 in serum and cerebrospinal fluid. Arch Neurol 47:477, 1990. 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