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TSP/HAM is present in most HTLV-I endemic areas,with a prevalence ranging from 5.1 to 128 per 100,000 inhabitants.Up to 20%of patients develop TSP/ HAM after transfusion of TH==HTLV-I contaminated blood.Pathologic characteristics indicate a chronic meningomyelitis.The clinical features consist of a chronic progressive spastic paraparesis or paraplegia, sphincter disturbances,and minimal sensory loss.Supraspinal and peripheral nerve involvement is sometimes observed.High titers of HTLV-I-specific antibodies are present in the serum and cerebrospinal fluid.The high level of humoral and cellular immunologic response and the association of TSP/ HAM with other immunologic diseases suggest an immune-mediated process. Corticosteroids and immunosuppressor treatment usually result in only short-term improvement.TSP/HAM is a common neurologic disease in many parts of the world.All patients with chronic progressive myelopathies should be tested for serum and cerebrospinal fluid HTLV-I-specific antibodies.Systematic screening of blood donors for HTLV-I is necessary to help prevent the dissemination of the virus and the occurrence of post- transfusional cases. |
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human T-lymphotropic virus type I(HTLV-I)
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