| Title | Early Neurologic Abnormalities Associated with Human T-Cell Lymphotropic Virus Type 1 Infection in a Cohort of Peruvian Children. | | Author(s) | Kendall EA, González E, Espinoza I, Tipismana M, Verdonck K, Clark D, Vermund SH, Gotuzzo E | | Institution | Institute for Global Health and Department of Pediatrics (E.A.K., S.H.V.), Vanderbilt University School of Medicine, Nashville, TN; Instituto de Medicina Tropical "Alexander von Humboldt" (E.G., I.G., M.T., K.V., D.C., E.G.), Universidad Peruana Cayetano Heredia, Lima, Peru; the Department of Pediatrics (I.E.); Neurology Service (M.T.) and the Department of Infectious, Tropical, and Dermatological Diseases (E.G.), Hospital Nacional Cayetano Heredia Lima, Peru; Laboratorios de Investigación y Desarrollo (K.V.), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú; and the Virology Unit (D.C.), the Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium. | | Source | J Pediatr 2009 Jul 21. | | Abstract | 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. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19628219 |
|
