Document Detail


Early neurologic abnormalities associated with human T-cell lymphotropic virus type 1 infection in a cohort of Peruvian children.
MedLine Citation:
PMID:  19628219     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Because human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may occur in some children infected with HTLV-1, we sought to determine the prevalence of neurologic abnormalities and any associations of neurologic abnormalities with infective dermatitis in these children.
STUDY DESIGN: We enrolled 58 children infected with HTLV-1 and 42 uninfected children (ages 3 to 17) of mothers infected with HTLV-1 in a family study in Lima, Peru. We obtained medical and developmental histories, surveyed current neurologic symptoms, and conducted a standardized neurologic examination without prior knowledge of HTLV-1 status.
RESULTS: HTLV-1 infection was associated with reported symptoms of lower extremity weakness/fatigue (odds ratio [OR], 6.1; confidence interval [CI], 0.7 to 281), lumbar pain (OR, 1.7; 95% CI, 0.4 to 8), and paresthesia/dysesthesia (OR, 2.6; CI, 0.6 to 15.8). HTLV-1 infection was associated with lower-extremity hyperreflexia (OR, 3.1; CI, 0.8 to 14.2), ankle clonus (OR, 5.0; CI, 1.0 to 48.3), and extensor plantar reflex (OR undefined; P = .2). Among children infected with HTLV-1, a history of infective dermatitis was associated with weakness (OR, 2.7; CI, 0.3 to 33), lumbar pain (OR, 1.3; CI, 0.2 to 8), paresthesia/dysesthesia (OR, 2.9; CI, 0.5 to 20), and urinary disturbances (OR, 5.7; CI, 0.5 to 290).
CONCLUSIONS: Abnormal neurologic findings were common in Peruvian children infected with HTLV-1, and several findings were co-prevalent with infective dermatitis. Pediatricians should monitor children infected with HTLV-1 for neurologic abnormalities.
Authors:
Emily A Kendall; Elsa González; Iván Espinoza; Martín Tipismana; Kristien Verdonck; Daniel Clark; Sten H Vermund; Eduardo Gotuzzo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-07-22
Journal Detail:
Title:  The Journal of pediatrics     Volume:  155     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-12-01     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  700-6     Citation Subset:  AIM; IM    
Affiliation:
Institute for Global Health, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Distribution
Age of Onset
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Confidence Intervals
Female
HTLV-I Infections / diagnosis,  epidemiology*,  transmission
Human T-lymphotropic virus 1 / isolation & purification*
Humans
Infectious Disease Transmission, Vertical
Male
Neurologic Examination
Odds Ratio
Paraparesis / diagnosis,  epidemiology*
Paraparesis, Tropical Spastic / diagnosis,  epidemiology
Peru / epidemiology
Prevalence
Probability
Risk Assessment
Severity of Illness Index
Sex Distribution
Spinal Cord Diseases / diagnosis,  epidemiology*
Time Factors
Urination Disorders / diagnosis,  epidemiology
Grant Support
ID/Acronym/Agency:
P30 AI054999-05/AI/NIAID NIH HHS; P30AI054999/AI/NIAID NIH HHS; R25 TW007766/TW/FIC NIH HHS; R25 TW007766-03/TW/FIC NIH HHS; R25TW007766/TW/FIC NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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