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Human T-cell lymphotrophic virus type II(HTLV-II)is endemic in several ethnic tribes and among intravenous drug users in metropolitan areas. Despite the presence of HTLV-II in these various populations,the association of HTLV-II with disease is sparse and mainly limited to isolated case reports.This study is an extension of an earlier description of an HTLV-II infected patient with neurologic disease and presents the clinical and immunologic findings of 4 patients with HTLV-II seropositivity and spastic paraparesis.The patients are of African- American origin with 3 of the patients being of Amerindian descent.All of the patient are seronegative for the human immunodeficiency virus(HIV).The patients progressed to a nonambulatory state in less than 5 years.Magnetic resonance imaging studies obtained from 3 of the patients demonstrated white matter disease in the cerebrum and spinal cord.The cerebrospinal fluid and serum contained antibodies to HTLV-II.The presence of proviral HTLV-II was confirmed by polymerase chain reaction analysis of peripheral blood lymphocytes(PBLs).A spinal cord biopsy from 1 patient demonstrated HTLV RNA within a lesion.Immunologic studies on 2 patients demonstrated that spontaneous lymphoproliferation of PBLs was present but decreased relative to HTLV-1-infected patients.The clinical immunologic findings from these HTLV-II-infected patients resemble those found in HTLV-I- associated myelopathy/tropical spastic paraparesis. |
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blacks
cerebrospinal fluid,abnormal
drug abuse
drug abuse,neurologic complications of
human T-lymphotropic virus type II(HTLV-II)
leg weakness,bilateral
MRI
MRI,abnormal
MRI,spinal cord
MRI,spinal cord,increased intramedullary cord signal
myelopathy
Native Americans
paraparesis
paraparesis,spastic
polymerase chain reaction
quadriparesis
spinal cord,biopsy
viral infection
viral infection,CNS
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