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Chronic dacryosialadenitis in HTLV I associated myelopathy
L Cartier1, J L Castillo, J G Cea
1Departamento de Ciencias Neurológicas, Universidad de Chile.
Abstract:
A prospective study was carried out on 48 patients with HTLV I associated myelopathy/tropical spastic paraparesis (HAM/TSP) to assess the association between this entity and Sjögren's syndrome. Fourteen patients (29.1%) had chronic dacryosialadenitis confirmed by a positive Schirmer's test and salivary gland biopsy. None of these patients had evidence of collagen disease and tests for Ro, La, and rheumatoid factor were negative except in one case. Therefore, the dacryosialadenitis could not be classified as either primary or secondary Sjögren's syndrome. Ten of the 14 patients (71.4%) had other systems (haematological, articular, dermatological, or respiratory) involved apart from the neurological and exocrine gland pathology. The findings suggest that the dacryosialadenitis associated with HTLV I is a disease of viral origin distinct from Sjögren's syndrome.
Insights
Human T-lymphotropic virus type 1 (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients may develop chronic dacryosialadenitis. This condition appears distinct from Sjögren
Area of Science:
- Neurology
- Immunology
- Ophthalmology
Background:
- Human T-lymphotropic virus type 1 (HTLV-I) infection is linked to neurological disorders like HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).
- Sjögren's syndrome is an autoimmune disorder affecting exocrine glands, primarily salivary and lacrimal glands.
Purpose of the Study:
- To investigate the prevalence and characteristics of chronic dacryosialadenitis in patients with HAM/TSP.
- To determine if dacryosialadenitis in HAM/TSP patients represents Sjögren's syndrome or a distinct viral-related condition.
Main Methods:
- A prospective study involving 48 patients diagnosed with HAM/TSP.
- Assessment included clinical evaluation, Schirmer's test for dry eyes, and salivary gland biopsy.
- Serological tests for autoimmune markers (Ro, La, rheumatoid factor) and assessment for collagen diseases were performed.
Main Results:
- Fourteen out of 48 (29.1%) HAM/TSP patients presented with chronic dacryosialadenitis.
- Autoimmune markers and evidence of collagen disease were largely negative, precluding classification as primary or secondary Sjögren's syndrome.
- Systemic involvement (hematological, articular, dermatological, respiratory) was observed in 10 of the 14 affected patients.
Conclusions:
- The dacryosialadenitis observed in HAM/TSP patients is likely a distinct entity.
- Findings suggest a viral etiology for dacryosialadenitis associated with HTLV-I, differentiating it from Sjögren's syndrome.