Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical
The Human T cells Lymphotropic Virus (HTLV-1 and HTLV-2) are retrovirus which cause the adult T cell lymphoma/leukemia (ATL) and tropical spastic paraparesis (TSP) or HTLV-associated myelopathy (HAM). Other neurologic presentations are finding include sensory disturbances and hyperactive reflexes. T...
| Autor principal: | NUNES, Ana Flávia Endres |
|---|---|
| Grau: | Dissertação |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Pará
2013
|
| Assuntos: | |
| Acesso em linha: |
http://repositorio.ufpa.br/jspui/handle/2011/3788 |
| id |
ir-2011-3788 |
|---|---|
| recordtype |
dspace |
| spelling |
ir-2011-37882019-05-21T15:31:24Z Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical NUNES, Ana Flávia Endres SOUSA, Rita Catarina Medeiros http://lattes.cnpq.br/3560941703812539 Vírus linfotrópico de células T humanas tipo 1 Vírus 2 linfotrópico T humano Paraparesia espástica tropical Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS The Human T cells Lymphotropic Virus (HTLV-1 and HTLV-2) are retrovirus which cause the adult T cell lymphoma/leukemia (ATL) and tropical spastic paraparesis (TSP) or HTLV-associated myelopathy (HAM). Other neurologic presentations are finding include sensory disturbances and hyperactive reflexes. The prevalence of the HTLV-1 infection in Brazil is elevated (0, 8 - 1, 8%), the HTLV-1 and HTLV-2 are endemic in the Amazon region. The health care professional knows a little bit about the HTLV infection and the diseases related to these virus. This is a transversal description, case-control study with 76 patients’ carriers of the HTLV-1 and 2 admitted in the Núcleo de Medicina Tropical at Belém-Pará. The patients were submitted to clinical, functional (OMDS), neurological, laboratorial (TCD4+ lymphocytes count, proviral load quantification) evaluations and nuclear magnetic resonance (NMR). The patients HTLV-1 with abnormal neurologic findings were the cases (n=19) and the patients asymptomatic with normal neurological evaluation were the cases-control (n=40). The female sex were 66.1%, the media age was 50.7 years. The distribution of the average TCD4+ lymphocytes count in the two groups was within the normal reference values; the proviral load was more elevated in the cases group. The search of antibody anti-HTLV-1 in the cerebrospinal fluid was positive in 93, 3% of the cases. The neurological evaluation showed 16 patients (84, 2%) with TSP/HAM (p<0.0001). In fourteen cases (73, 7%) the length of the disease was between 4-9 years. The evaluation of mass muscle strength flexor and extension of the knees showed that 63.2% of the cases had 3 degree and 68.4% had 4 degree, respectively (p<0.0001). The reflexes were normal MMSS, patellar reflex and Achilles tendon reflex were hyperactive in 78.9% and 73.7%, respectively. Babinski bilateral signal was detected in 73.7% of the cases and Hoffman signal in 26.3%. Bilateral clonus was present in 13 patients. Tactual sensibility was abnormal (31.6%), mass muscle strength of legs was stronger than normal (63.2%) and the cases had also urine symptoms (89.5%). In 17 NMR done, 13 (76.47%) had abnormal image in the thoracic bone marrow. There were not associations between proviral load, OMDS, duration of the disease and NMR findings. The most of the cases with neurological disease related to the HTLV-1 were consistent with TSP/HAM; the elevated proviral load seems to be a marker of the development of the disease. Programa Nacional de DST/AIDS SUS - Sistema Único de Saúde do Ministério da Saúde do Brasil Os vírus linfotrópicos de células T humano do tipo 1 e 2 (HTLV-1 e 2) são retrovírus que causam o Leucemia / Linfoma de células T do adulto (LLTA) e a Paraparesia Espástica Tropical ou Mielopatia associada ao HTLV-1(PET/MAH). Outras manifestações neurológicas também têm sido atribuídas ao vírus, tais como distúrbios sensoriais e reflexos hiperativos. A prevalência da infecção pelo HTLV-1 no Brasil é alta (0,8% a 1,8%); os HTLV 1 e 2 são endêmicos na região Amazônica. A infecção pelo HTLV e suas doenças associadas ainda são pouco conhecidas dos profissionais de saúde. Trata-se de um estudo descritivo transversal, tipo caso-controle com uma amostra de 76 pacientes portadores do HTLV-1/2 assistidos no Núcleo de Medicina Tropical, em Belém-Pará. Foram submetidos a avaliações clínico-funcional (OMDS), neurológica, laboratoriais (contagem de linfócitos T CD4+, quantificação da carga proviral) e exame de imagem de ressonância magnética (RNM). Os pacientes com HTLV-1com avaliação neurológica foram considerados casos (n=19) e os pacientes assintomáticos sem alteração neurológica foram os controles (n=40). O sexo feminino foi mais prevalente (66,1%), a média de idade foi de 50.7 anos. A distribuição média da contagem de linfócitos T CD4+ nos dois grupos esteve dentro da faixa da normalidade, a carga proviral mostrou-se mais elevada no grupo de casos, a pesquisa do anticorpo anti-HTLV-1 no LCR foi positiva em 93,3% dos casos. A avaliação neurológica revelou 16 (84.2%) pacientes com PET/MAH (p<0.0001). Em 73.7% (14) dos casos, a duração da doença ficou entre 4 a 9 anos. A pesquisa da força muscular em flexão e extensão dos joelhos mostrou que 63.2% dos casos apresentavam grau 3 e 68.4% grau 4, respectivamente (p<0.0001). Normorreflexia em MMSS, além de hiperreflexia no patelar e no Aquileu, em 78.9% e 73.7%, respectivamente. Sinal de Babinski bilateral foi visto em 73.7% dos casos e o sinal de Hoffman em 26.3%. Clônus bilateral esteve presente em 13 pacientes. Sensibilidade tátil alterada (31.6%), hipertonia de MMII (63.2%) e sintomas urinários foram observados em 89.5% dos casos. Das 17 RNM realizadas, 13 (76.47) tinham alteração de imagem em medula torácica. Não houve associações entre carga proviral, OMDS, duração da doença e RNM. A maioria dos casos de doença neurológica associada ao HTLV-1 era compatível com PET/MAH; a carga proviral elevada perece ser um marcador de desenvolvimento de doença. 2013-05-02T16:31:02Z 2013-05-02T16:31:02Z 2008-06-26 Dissertação NUNES, Ana Flávia Endres. Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical. 2008. 87 f. Dissertação (Mestrado) - Universidade Federal do Pará, Núcleo de Medicina Tropical, Belém, 2008. Programa de Pós-Graduação em Doenças Tropicais. http://repositorio.ufpa.br/jspui/handle/2011/3788 por Acesso Aberto application/pdf Universidade Federal do Pará Brasil Núcleo de Medicina Tropical UFPA Programa de Pós-Graduação em Doenças Tropicais |
| institution |
Repositório Institucional - Universidade Federal do Pará |
| collection |
RI-UFPA |
| language |
por |
| topic |
Vírus linfotrópico de células T humanas tipo 1 Vírus 2 linfotrópico T humano Paraparesia espástica tropical Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
| spellingShingle |
Vírus linfotrópico de células T humanas tipo 1 Vírus 2 linfotrópico T humano Paraparesia espástica tropical Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS NUNES, Ana Flávia Endres Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| topic_facet |
Vírus linfotrópico de células T humanas tipo 1 Vírus 2 linfotrópico T humano Paraparesia espástica tropical Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
| description |
The Human T cells Lymphotropic Virus (HTLV-1 and HTLV-2) are retrovirus which cause the adult T cell lymphoma/leukemia (ATL) and tropical spastic paraparesis (TSP) or HTLV-associated myelopathy (HAM). Other neurologic presentations are finding include sensory disturbances and hyperactive reflexes. The prevalence of the HTLV-1 infection in Brazil is elevated (0, 8 - 1, 8%), the HTLV-1 and HTLV-2 are endemic in the Amazon region. The health care professional knows a little bit about the HTLV infection and the diseases related to these virus. This is a transversal description, case-control study with 76 patients’ carriers of the HTLV-1 and 2 admitted in the Núcleo de Medicina Tropical at Belém-Pará. The patients were submitted to clinical, functional (OMDS), neurological, laboratorial (TCD4+ lymphocytes count, proviral load quantification) evaluations and nuclear magnetic resonance (NMR). The patients HTLV-1 with abnormal neurologic findings were the cases (n=19) and the patients asymptomatic with normal neurological evaluation were the cases-control (n=40). The female sex were 66.1%, the media age was 50.7 years. The distribution of the average TCD4+ lymphocytes count in the two groups was within the normal reference values; the proviral load was more elevated in the cases group. The search of antibody anti-HTLV-1 in the cerebrospinal fluid was positive in 93, 3% of the cases. The neurological evaluation showed 16 patients (84, 2%) with TSP/HAM (p<0.0001). In fourteen cases (73, 7%) the length of the disease was between 4-9 years. The evaluation of mass muscle strength flexor and extension of the knees showed that 63.2% of the cases had 3 degree and 68.4% had 4 degree, respectively (p<0.0001). The reflexes were normal MMSS, patellar reflex and Achilles tendon reflex were hyperactive in 78.9% and 73.7%, respectively. Babinski bilateral signal was detected in 73.7% of the cases and Hoffman signal in 26.3%. Bilateral clonus was present in 13 patients. Tactual sensibility was abnormal (31.6%), mass muscle strength of legs was stronger than normal (63.2%) and the cases had also urine symptoms (89.5%). In 17 NMR done, 13 (76.47%) had abnormal image in the thoracic bone marrow. There were not associations between proviral load, OMDS, duration of the disease and NMR findings. The most of the cases with neurological disease related to the HTLV-1 were consistent with TSP/HAM; the elevated proviral load seems to be a marker of the development of the disease. |
| author_additional |
SOUSA, Rita Catarina Medeiros |
| author_additionalStr |
SOUSA, Rita Catarina Medeiros |
| format |
Dissertação |
| author |
NUNES, Ana Flávia Endres |
| title |
Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| title_short |
Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| title_full |
Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| title_fullStr |
Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| title_full_unstemmed |
Doença neurológica pelo vírus linfotrópico de célula T humana - HTLV: achados clínico-funcionais e virológicos de pacientes do Núcleo de Medicina Tropical |
| title_sort |
doença neurológica pelo vírus linfotrópico de célula t humana - htlv: achados clínico-funcionais e virológicos de pacientes do núcleo de medicina tropical |
| publisher |
Universidade Federal do Pará |
| publishDate |
2013 |
| url |
http://repositorio.ufpa.br/jspui/handle/2011/3788 |
| _version_ |
1787147613781360640 |
| score |
11.675088 |