Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/ tropical spastic paraparesis from the Brazilian Amazon
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2017
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Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin
were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females,
median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males,
median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6
years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin
was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in
CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts,
protein and glucose were measured, the Osame’s motor-disability-score/OMDS was determined,
and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients
had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8:
9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration
in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers
(4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min.
2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were
higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar
serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and
laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin
measurement as a potential biomarker of disease activity.
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HAM/TSP patients, HTLV-I carriers, Neopterin, Cerebrospinal fluid
Citação
TAKATANI, Massanobu et al. Clinical and laboratory features of HTLV-1 asymptomatic carriers and patients with HTLV-1-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon. Revista do Instituto de Medicina Tropical de São Paulo, São Paulo, v. 59, e5, 2017. DOI: 10.1590/S1678-9946201759005. Disponível em: https://www.scielo.br/j/rimtsp/a/8rmYVBKKRfg4bG4kwQkSmzC/?lang=en. Acesso em: 12 fev. 2025.