出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/08/31 14:50:55」(JST)
| Tropical spastic paraparesis | |
|---|---|
| HTLV-1 which causes TSP | |
| Classification and external resources | |
| Specialty | neurology |
| ICD-10 | G04.1 |
| DiseasesDB | 29487 |
| eMedicine | med/1038 |
| Patient UK | Tropical spastic paraparesis |
| MeSH | D015493 |
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[edit on Wikidata]
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Tropical spastic paraparesis (TSP), also called HTLV-I-associated myelopathy (HAM) or HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP)[1] is a medical condition that causes weakness, muscle spasms, and sensory disturbance by human T-lymphotropic virus resulting in paraparesis, weakness of the legs. As the name suggests, it is most common in tropical regions, including the Caribbean.[2] Blood transfusion products are screened for HTLV-1 antibodies, as a preventive measure.[3]
Some of the signs of Tropical spastic paraparesis are:[4]
Patients with TSP may also exhibit uveitis (inflammation of the uveal tract of the eye), arthritis (inflammation of one or more joints), pulmonary lymphocytic alveolitis (inflammation of the lung tissues), polymyositis (an inflammatory muscle disease), keratoconjunctivitis sicca (persistent dryness of the cornea and conjunctiva), and infectious dermatitis (inflammation of the skin).[5]
HTLV-1 can be transmitted via breastfeeding (mother to child), sexual contact, via blood contact (transfusion or needle sharing).[6]
In Tropical spastic paraparesis, HTLV-1 shows elevated cellular acquired immune response as well as high production of proinflammatory cytokines. IFN overexpression has been demonstrated as well. Also the number of NK cells (CD56+ and CD16+) is diminished.[7]
Among the methods of diagnosing tropical spastic paraparesis are MRI (magnetic resonance imaging) and lumbar puncture (which may show lymphocytosis).[4]
Treatment of TSP involves corticosteroids to help with inflammation. Though any success with corticosteroids is short-lived, with symptoms worsened as the dosage is reduced. A synthetic derivative, 17-alpha-ethinyltestosterone, can be used to treat Tropical spastic paraparesis, improvement in motor and bladder function was reported but not sustainable.[8]
Mogamulizumab, an anti-CCR4 IgG1 monoclonal antibody, is also being researched as a possible treatment for Tropical spastic paraparesis. The antibody reduces HTLV-1 proviral load and production of proinflammatory cytokines. Valproic acid has also succeeded in reducing the proviral load of HTLV-1 (though clinical benefits were minimal or none). A further combination of valproic acid and zidovudine has demonstrated a decrease in proviral loads (in animals).[9]
The prognosis for Tropical spastic paraparesis indicates some improvement in a percentage of cases due to immunosuppressive treatment. A higher percentage will eventually lose the ability to walk within a ten-year interval.[10]
For several decades, the term tropical spastic paraparesis was used to describe a chronic and progressive clinical syndrome that affected adults living in equatorial areas of the world. This condition was initially thought to be associated with infectious agents (such as Treponema pertenue and Treponema pallidum, which cause inflammation of the central nervous system) and with chronic nutritional deficiencies (such as avitaminosis) or exposure to potentially toxic foods (such as bitter cassava).[medical citation needed]
Tropical myeloneuropathies are classified as two separate syndromes: tropical ataxic neuropathy (TAN) and tropical spastic paraparesis (TSP). They are placed together because they are found in tropical countries, although tropical spastic paraparesis has occurred in temperate countries (e.g., Japan).[11]
Pathology of the nervous system, primarily CNS (G04–G47, 323–349)
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| Inflammation |
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| Brain/ encephalopathy |
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| Spinal cord/ myelopathy |
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| Both/either |
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Infectious diseases – viral systemic diseases (A80–B34, 042–079)
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| Oncovirus |
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| Immune disorders |
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| Central nervous system |
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| Cardiovascular |
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| Respiratory system/ acute viral nasopharyngitis/ |
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| Human digestive system |
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| Urogenital |
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| リンク元 | 「HTLV-1関連脊髄症」 |
| 関連記事 | 「associate」「I」「associated」「HT」「Id」 |
HTLV-1型関連ミエロパシー : nothing HTLV-1型関連ミエロパチー : nothing HTLV-1脊髄症 : 30 件 HTLV-I型関連ミエロパシー : 9 件 HTLV-I型関連ミエロパチー : nothing HTLV-I脊髄症 : 70 件 ヒトT細胞白血病ウイルス関連脊髄症 : 4 件 ヒトTリンパ球向性ウイルス脊髄症 : 49 件 ヒトT細胞白血病ウイルスI型関連ミエロパシー : 2 件 ヒトTリンパ好性ウイルスI型関連脊髄症 : 10 件 ヒトTリンパ球関連ウイルス脊髄症 : nothing