Human T-cell lymphotropic virus type I and neurologic disease in Panama, 1985 and 1986
F. Gracia, W. C. Reeves, P. H. Levine, M. Cuevas, L. Castillo, R. Chavarria, V. Grimaldo, E. Triana, J. R. Arosemena and W. A. Blattner
Neurology Service, Santo Tomas Hospital, Panama City, Panama.
Human T-cell lymphotropic virus type I (HTLV-I) causes adult T-cell
leukemia and has recently been associated with HTLV-associated
myelopathy/tropical spastic paraparesis. The HTLV-I is endemic throughout
the Caribbean basin and parts of South America, and HTLV-associated
myelopathy/tropical spastic paraparesis also seems to be common in this
area. This 2-year study, 1985 and 1986, was designed to evaluate the
occurrence of HTLV-I infection in all newly diagnosed cases of selected
neurologic diseases in Panama City, Panama. Six (8%) of 71 patients had
antibody to HTLV-I detected by immunofluorescence, enzyme-linked
immunosorbent assay, radioimmunoassay, and Western blot assays; 5 patients'
conditions were diagnosed as spastic paraparesis, and all 5 were
seropositive and also had HTLV-I antibody in cerebrospinal fluid. The
remaining seropositive patient had multiple sclerosis, and no antibody was
detected in her cerebrospinal fluid. Clinical and electrophysiologic
studies indicated that HTLV-I-associated spastic paraparesis is a
multifocal, primarily demyelinating disease that principally involves the
spinal cord.