HTLV-I associated uveitis, myelopathy, rheumatoid arthritis and Sjögren's syndrome. 1995

S R Pinheiro, and M A Lana-Peixoto, and A B Proietti, and F Oréfice, and M V Lima-Martins, and F A Proietti
Department of Ophthalmology, Federal University of Minas Gerais Medical School, Rua São Paulo, Brasil.

A 62 year-old white female presented with a 10-year-history of slowly progressive spastic paraparesis, pain and dysesthesia in the lower limbs and sphincter disturbance. A few years after the onset of the neurologic symptoms she developped migratory arthritis with swelling of the knees and pain on palpation of knees and fingers, dry eyes, mouth and skin. Two months before admission she presented bilateral nongranulomatous anterior uveitis. Examination revealed spastic paraparesis with bilateral Babinski sign, a decreased sensation level below L3, decreased vibration sense in the lower extremities, and a postural tremor of the upper limbs. Laboratory work-up disclosed HTLV-I positive tests in the blood and cerebrospinal fluid (CSF), and a mild pleocytosis in the CSF with a normal protein content. Nerve conduction velocity studies were normal. The present case shows the association of uveitis, arthritis and Sjögren's syndrome in a patient with tropical spastic paraparesis/human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy (TSP/HAM), and illustrates the wide spectrum of clinical manifestations which may accompany this infection with this virus.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001172 Arthritis, Rheumatoid A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. Rheumatoid Arthritis
D012859 Sjogren's Syndrome Chronic inflammatory and autoimmune disease in which the salivary and lacrimal glands undergo progressive destruction by lymphocytes and plasma cells resulting in decreased production of saliva and tears. The primary form, often called sicca syndrome, involves both KERATOCONJUNCTIVITIS SICCA and XEROSTOMIA. The secondary form includes, in addition, the presence of a connective tissue disease, usually rheumatoid arthritis. Sicca Syndrome,Sjogren Syndrome,Sjogrens Syndrome,Syndrome, Sicca,Syndrome, Sjogren's
D014606 Uveitis, Anterior Inflammation of the anterior uvea comprising the iris, angle structures, and the ciliary body. Manifestations of this disorder include ciliary injection, exudation into the anterior chamber, iris changes, and adhesions between the iris and lens (posterior synechiae). Intraocular pressure may be increased or reduced. Anterior Uveitides,Anterior Uveitis,Uveitides, Anterior
D015490 HTLV-I Infections Diseases caused by HUMAN T-LYMPHOTROPIC VIRUS 1. Human T-lymphotropic Virus 1 Infection,Human T-lymphotropic Virus 1 Infections,Infections, HTLV-I,HTLV I Infections,HTLV-I Infection,Human T lymphotropic Virus 1 Infection,Human T lymphotropic Virus 1 Infections,Infection, HTLV-I,Infections, HTLV I
D015493 Paraparesis, Tropical Spastic A subacute paralytic myeloneuropathy occurring endemically in tropical areas such as the Caribbean, Colombia, India, and Africa, as well as in the southwestern region of Japan; associated with infection by HUMAN T-CELL LEUKEMIA VIRUS I. Clinical manifestations include a slowly progressive spastic weakness of the legs, increased reflexes, Babinski signs, incontinence, and loss of vibratory and position sensation. On pathologic examination inflammatory, demyelination, and necrotic lesions may be found in the spinal cord. (Adams et al., Principles of Neurology, 6th ed, p1239) HTLV-I-Associated Myelopathy,Tropical Spastic Paraparesis,Familial Spastic Paraparesis, Htlv-1-Associated,HTLV I Associated Myelopathies,HTLV-I-Associated Myelopathy-Tropical Spastic Paraparesis,Human T-Lymphotropic Virus Type 1 Associated Myelopathy,Myelopathies, HTLV I Associated,Myelopathy, Htlv-1-Associated,Myelopathy, Human T-Lymphotropic Virus Type 1 Associated,Paraplegia, Tropical Spastic,Familial Spastic Paraparesis, Htlv 1 Associated,HTLV I Associated Myelopathy,HTLV I Associated Myelopathy Tropical Spastic Paraparesis,HTLV-I-Associated Myelopathies,Htlv-1-Associated Myelopathies,Htlv-1-Associated Myelopathy,Human T Lymphotropic Virus Type 1 Associated Myelopathy,Myelopathies, HTLV-I-Associated,Myelopathies, Htlv-1-Associated,Myelopathy, HTLV-I-Associated,Myelopathy, Htlv 1 Associated,Myelopathy, Human T Lymphotropic Virus Type 1 Associated,Parapareses, Tropical Spastic,Paraplegias, Tropical Spastic,Spastic Parapareses, Tropical,Spastic Paraparesis, Tropical,Spastic Paraplegia, Tropical,Spastic Paraplegias, Tropical,Tropical Spastic Parapareses,Tropical Spastic Paraplegia,Tropical Spastic Paraplegias

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