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Encyclopedia > Tropical spastic paraparesis

Tropical spastic paraparesis (TSP) is an infection of the spinal cord by Human T-lymphotropic virus resulting in paraparesis or weakness of the legs. As the name suggests, it is most common in tropical regions, including the Caribbean and Africa. Infected (Podcast) is also the name of an internet radio podcast hosted by Martin Sargent. ... Cross-section through cervical spinal cord. ... Human T-lymphotropic virus (HTLV) is a human, single-stranded RNA retrovirus that causes T-cell leukemia and T-cell lymphoma in adults and may also be involved in certain demyelinating diseases. ... The tropics are the geographic region of the Earth centered on the equator and limited in latitude by the two tropics: the Tropic of Cancer in the north and the Tropic of Capricorn in the southern hemisphere. ... Central America and the Caribbean (detailed pdf map) The Caribbean, (Spanish: Caribe; French: Caraïbe or more commonly Antilles; Dutch: Cariben or Caraïben, or more commonly Antillen) or the West Indies, is a group of islands and countries which are in or border the Caribbean Sea which lies on... A satellite composite image of Africa Africa is the worlds second largest and second most populous continent, after Asia. ...


For several decades the term tropical spastic paraparesis was used to describe a chronic and progressive clinical syndrome that affected adults living in equatorial areas of the world. This condition was initially thought to be associated with infectious agents (such as Treponema pertenue and Treponema pallidum which cause inflammation of the central nervous system) and with chronic nutritional deficiencies (such as avitaminosis) or exposure to potentially toxic foods (such as bitter cassava). Neurological and modern neuroepidemiological studies found that in some individuals no single cause could explain the progressive weakness, sensory disturbance, and sphincter dysfunction that affected individuals with TSP. In spite of public health programs created to eradicate the above-mentioned infectious and nutritional conditions in the tropics, large numbers of people continued to be affected. Yaws (also Frambesia tropica, thymosis, polypapilloma tropicum or pian) is a tropical infection of the skin, bones and joints caused by the spirochete bacterium Treponema pertenue. ... Binomial name Treponema pallidum Schaudinn & Hoffmann, 1905 Treponema pallidum is a spirochaete bacterium. ... A diagram showing the CNS: 1. ... Avitaminosis is any disease caused by chronic or long-term vitamin deficiency or caused by a defect in metabolic conversion, such as tryptophan to niacin. ... Binomial name Manihot esculenta Crantz The cassava or manioc (Manihot esculenta) is a woody Shrub of the Euphorbiaceae (spurge family) that is extensively cultivated as an annual crop in tropical and subtropical regions for its edible starchy tuberous root, a major source of carbohydrate. ...


During the mid-1980's, an important association was established between the first human retrovirus-human T-cell lymphotrophic virus type 1 (also known as HTLV-1)-and idiopathic TSP (idiopathic means of unknown origin). Since then, this condition has been named HTLV-1 associated myelopathy/ tropical spastic paraparesis or HAM/TSP and scientists now understand that it is a condition caused by a virus that results in immune dysfunction. Patients with HAM/TSP may also exhibit uveitis (inflammation of the uveal tract of the eye), arthritis (inflammation of one or more joints), pulmonary lymphocytic alveolitis (inflammation of the lung tissues), polymyositis (an inflammatory muscle disease), keratoconjunctivitis sicca (persistent dryness of the cornea and conjunctiva), and infectious dermatitis (inflammation of the skin). Co-factors that may play a role in transmitting the disorder include being a recipient of transfusion blood products (especially before 1989), breastmilk feeding from a seropositive mother, intravenous drug use, or being the sexual partner of a seropositive individual for several years. Not every HTLV-1 seropositive carrier will become a HAM/TSP patient. Fewer than 5% will exhibit neurological dysfunction or, eventually, hematological malignancy such as adult T-cell leukemia or lymphoma suggesting that other host or viral factors are responsible for disease onset. The human immunodeficiency virus (HIV) A bacteriophage virus A virus is a submicroscopic obligate parasitic particle that infects cells in biological organisms. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Arthritis (from Greek arthro-, joint + -itis, inflammation) is a group of conditions that affect the health of the bone joints in the body. ... Polymyositis A type of Inflammatory Myopathy, related to Dermatomyositis and Inclusion body myositis. ... Keratoconjunctivitis sicca (KCS), also called keratitis sicca, xerophthalmia, dry eye syndrome, or simply dry eyes, is an eye disease caused by decreased tear production or increased tear film evaporation commonly found in humans and small animals. ... A commonly used term for a postive serum reaction. ... An intravenous drug (IV drug) is a drug administered intravenously, either by an intravenous drip or a syringe. ... Human T cell leukemia/lymphotropic virus type 1 (HTLV-1) is believed to be the cause of several diseases, including adult T cell leukemia/lymphoma (ATLL), a rare cancer of the immune systems own T-cells. ... Lymphoma is a general term for a variety of cancer that begins in the lymphatic system. ...

Contents


Pathogenesis

When infected by HTLV-1 the host mounts an antigen specific immune response towards the HTLV-1 antigen. Cytotoxic T-lymphocytes of the host’s immune response release cytokines in an effort to fight the infection. These cytokines facilitate the transendothelial migration of lymphocytes across the blood-brain barrier. Once cytokines are within the central nervous system demylination is brought as a result of bystander cell injury. The disease is chronic, progressing slowly, usually causing symptoms 20-30 years after infection. Human T-lymphotropic virus (HTLV) is a human, single-stranded RNA retrovirus that causes T-cell leukemia and T-cell lymphoma in adults and may also be involved in certain demyelinating diseases. ... Human T-lymphotropic virus (HTLV) is a human, single-stranded RNA retrovirus that causes T-cell leukemia and T-cell lymphoma in adults and may also be involved in certain demyelinating diseases. ... A cytotoxic (or TC) T cell is a T cell (a type of white blood cell) which has on its surface antigen receptors that can bind to fragments of antigens displayed by the Class I MHC molecules of virus (or other intracellular pathogen) infected somatic cells and tumor cells. ... Cytokines are small protein molecules that are the core of communication between immune system cells, and even between immune system cells and cells belonging to other tissue types. ... Cytokines are small protein molecules that are the core of communication between immune system cells, and even between immune system cells and cells belonging to other tissue types. ... A lymphocyte is a type of white blood cell involved in the human bodys immune system. ... Cytokines are small protein molecules that are the core of communication between immune system cells, and even between immune system cells and cells belonging to other tissue types. ... The word chronic comes from Chronos, the ancient Greek god of time. ...


Symptoms

Progressive muscle weakness; Sensory disturbance; Sphincter dysfunction; Urinary incontinence; Uveitis; arthritis; Pulmonary lymphocyte alveolitis; Polymyositis; Keratoconjunctivitis sicca; Infectious dermatitis; A sphincter is a ring-like muscle which normally maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological functioning. ... The urinary system is a system of organs, tubes, muscles, and nerves that work together to create, store, and carry, urine. ... Uveitis specifically refers to inflammation of the middle layer of the eye, termed the uvea but in common usage may refer to any inflammatory process involving the interior of the eye. ... Arthritis (from Greek arthro-, joint + -itis, inflammation) is a group of conditions that affect the health of the bone joints in the body. ... Polymyositis A type of Inflammatory Myopathy, related to Dermatomyositis and Inclusion body myositis. ... Keratoconjunctivitis sicca or KCS is an eye disease caused by decreased tear production or increased tear film evaporation commonly found in people and small animals. ... Dermatitis is a term literally meaning inflammation of the skin. It is usually used to refer to eczema, which is also known as Dermatitis eczema. ...


Prevention

Blood transfusion products are screened for HTLV-1 antibodies. Human T-lymphotropic virus (HTLV) is a human, single-stranded RNA retrovirus that causes T-cell leukemia and T-cell lymphoma in adults and may also be involved in certain demyelinating diseases. ...


Treatment

There is no established treatment program for HAM/TSP although some patients may be given steroids. Clinical studies using interferon alpha and plasmapheresis have not shown significant patient improvement. Spasticity may be treated with lioresal or tizanidine. Urinary dysfunction should be treated with self-catheterization or oxybutynin. Anabolic steroids are a class of natural and synthetic steroid hormones that promote cell growth and division, resulting in growth of several types of tissues, especially muscle and bone. ... Plasmapheresis is the removal of (components of) blood plasma from the circulation. ... Spasticity is a disorder of the bodys motor system in which certain muscles are continuously contracted. ... Tizanidine (Zanaflex) is a centrally acting a2-adrenergic agonist. ... Oxybutynin is an anti-cholinergenic pharmaceutical used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination. ...


Prognosis

HAM/TSP is usually a progressive neurological disorder but it is rarely fatal. Most patients live for several decades after the diagnosis. Their prognosis improves if they take steps to prevent urinary tract infection and skin sore formation, and if they enroll in physical and occupational therapy programs.


References

  • http://www.neurology.org/cgi/content/full/56/1/104

  Results from FactBites:
 
Tropical spastic paraparesis (286 words)
Tropical spastic paraparesis (TSP) is an incurable viral infection of the spinal cord that causes weakness in the legs.
TSP usually affects adults between the ages of 30 and 40 and is far more common in women than in men.
- Tropical spastic paraparesis (TSP) is an incurable viral infection of the spinal cord that causes weakness in the legs.
  More results at FactBites »

 
 

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