| Myelopathy associated with human T cell lymphotropic virus type I (HTLV-I) in natal, South Africa. A clinical and investigative study in 24 patients. | |
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MedLine Citation:
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PMID: 2245298 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Unexplained spastic myelopathy in black (Zulu) patients, similar to that seen in the tropics, has previously been described from Natal, South Africa. Following reports linking the human T cell lymphotropic virus type I (HTLV-I) to spastic myelopathy, we undertook a prospective and retrospective search for HTLV-I antibodies in 36 patients who were labelled as having unexplained myelopathy; 24 (66%) were positive and HTLV-I was isolated from 4 out of the 6 patients whose peripheral blood lymphocytes were cultured. Eighteen (75%) gave a short history (less than 6 months). There was a female preponderance (71%), spinothalamic dysfunction was common (55%) and as many as half were severely disabled (50% wheelchair bound). Routine laboratory studies showed no specific trends apart from hypergammaglobulinaemia and CSF pleocytosis (greater than 5 cells/microliter in 66% of patients). The total CSF protein was raised (greater than 0.4 g/l) in 45% of patients. The IgG index was greater than 0.7 in 15 of 19 patients. Conventional myelography did not show any specific abnormalities. Computer assisted myelography was undertaken in 22 patients; 3 showed arachnoiditis and 2 spinal cord atrophy. Periventricular lucencies were seen in 1 of 10 patients who had computed tomography of the head. Nerve conduction studies demonstrated abnormalities in 46% of the patients indicating that subclinical peripheral nerve dysfunction was common. Visual evoked responses were abnormal in only 1 patient but brainstem auditory evoked response studies showed some abnormality in 42% of the patients. The finding of HTLV-I antibodies in a significant number, and the isolation of HTLV-I from the blood in 6 of our black patients with noncompressive myelopathy, represents a substantial clinical advance. Future studies should define more clearly the role of the virus in this disorder. |
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Authors:
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A I Bhigjee; C Kelbe; H C Haribhai; I M Windsor; M H Hoffmann; G Modi; P L Bill; W B Becker; B Singh; S Engelbrecht |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Brain : a journal of neurology Volume: 113 ( Pt 5) ISSN: 0006-8950 ISO Abbreviation: Brain Publication Date: 1990 Oct |
Date Detail:
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Created Date: 1991-01-10 Completed Date: 1991-01-10 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372537 Medline TA: Brain Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 1307-20 Citation Subset: AIM; IM; X |
Affiliation:
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Department of Medicine, Faculty of Medicine, University of Natal, South Africa. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blotting, Western Electrophysiology Evoked Potentials Female HTLV-I Antibodies / analysis* Humans Male Nervous System / physiopathology Neural Conduction South Africa Spinal Cord Diseases / immunology*, physiopathology Spine / radiography |
| Chemical | |
Reg. No./Substance:
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0/HTLV-I Antibodies |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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