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[Human T-lymphotropic virus type 1 uveitis in children]
1Department of Ophthalmology, Kurume University School of Medicine, Fukuoka-ken, Japan.
Insights
Human T-lymphotropic virus type 1 (HTLV-I) uveitis can affect children, often transmitted through breastfeeding. Early diagnosis and consideration of HTLV-I are crucial for pediatric uveitis management.
Area of Science:
- Ophthalmology
- Virology
- Pediatrics
Background:
- Human T-lymphotropic virus type 1 (HTLV-I) is a known cause of uveitis in adults.
- Pediatric uveitis etiology can be diverse, requiring broad diagnostic considerations.
Observation:
- Five pediatric patients (3-14 years) presented with unilateral uveitis.
- Ocular symptoms mimicked adult HTLV-I uveitis and responded to corticosteroids but recurred in some.
- HTLV-I infection was confirmed via PCR in ocular cells and elevated in peripheral blood.
Findings:
- HTLV-I uveitis can manifest in children within 3-10 years of infection.
- Breastfeeding is a likely transmission route in pediatric cases.
- High viral loads were detected in affected children compared to asymptomatic carriers.
Implications:
- HTLV-I should be considered in the differential diagnosis of pediatric uveitis, especially in endemic regions.
- Early detection and management are vital for preventing recurrent ocular inflammation.
- This study highlights the potential for HTLV-I to cause significant ocular disease in children.
Abstract:
We report here five pediatric patients with human T-lymphotropic virus type 1 (HTLV-I) uveitis. The patients were one boy and four girls aged between 3 and 14 years. The transmission route was considered to be breast feeding from their mothers. All patients had unilateral uveitis and the ocular symptoms were similar to those in HTLV-I uveitis in adults. The ocular inflammation responded to therapy with topical or systemic corticosteroids, but recurred in three patients. HTLV-I provirus DNA was detected by polymerase chain reaction (PCR) from infiltrating cells in the anterior chamber in one patient. The percentage of HTLV-I-infected cells in the peripheral blood mononuclear cells was measured by quantitative PCR, and the values were high (2.9 approximately 7.3%) in three cases tested as compared with an asymptomatic carrier. These five cases show that HTLV-I uveitis can be induced in a relatively short period (3 approximately 10 years) after the viral infection, and that HTLV-I uveitis should be considered as one possible etiology of uveitis in children, particularly in a viral endemic area.