Un caso de leucemia cutánea / A case of cutaneous leukemia

Leucemia cutánea es una manisfestación extramedular de Leucemia. La frecuencia y edad de distribución depende del subtipo de leucemia1. Usualmente se presenta después que la enfermedad sistémica se ha manifestado y sugiere recaída o resistencia al tratamiento 11,12. Los hallazgos clínicos y morfológicos tienen una amplia variedad de manifestaciones y se pueden presentar en lesiones nodulares y placas. Raras manifestaciones incluyen máculas eritomatosas, ampollas y úlceras que pueden ocurrir solas o en combinación. A partir de una manifestación solitaria o en grupo, la leucemia cutis puede presentarse con rash eritematoso en un patrón clinicamente polimórfico. Consecuentemente , la leucemia cutánea debe distinguirse de diferentes diagnósticos diferenciales como por ejemplo: metástasis cutáneas o malignidades viscerales, linfoma, erupciones por fármacos, infecciones virales, sifilis, úlceras de varios orígenes. En la mucosa oral, hiperplasia gingival es el principal diagnóstico diferencial.1 El conocimiento de la morfologia clinica es de tremenda importancia en casos en donde la Leucemia no fuera conocida.1 Se presenta el caso poco frecuente de una paciente con diagnóstico de leucemia mieloide aguda que desarrolla una leucemia cutánea durante su seguimiento en Consulta Externa...(AU)

Cutaneous leukemia is an extramedullary manifestation of Leukemia. The frequency and age distribution depends on the subtype of leukemia1. It usually occurs after the systemic disease has manifested and suggests relapse or resistance to treatment 11,12. The clinical and morphological findings have a wide variety of manifestations and can occur in nodular lesions and plaques. Rare manifestations include erythematous macules, blisters and ulcers that can occur alone or in combination. From a solitary or group manifestation, leukemia cutis can present with erythematous rash in a clinically polymorphic pattern. Consequently, cutaneous leukemia must be distinguished from different differential diagnoses such as: cutaneous metastases or visceral malignancies, lymphoma, drug eruptions, viral infections, syphilis, ulcers of various origins. In the oral mucosa, gingival hyperplasia is the main differential diagnosis.1 The knowledge of the clinical morphology is of tremendous importance in cases where the Leukemia was not known.1 The rare case of a patient diagnosed with acute myeloid leukemia is presented that develops a cutaneous leukemia during its follow-up in Outpatient Consultation ... (AU)  

Khorasan disease: prevalence of HTLV-I associated myelopathy/tropical spastic paraparesis [HAM/TSP] in west Azarbaijan from 2004 to 2007

Because of the low prevalence of Human T Lymphotropic Virus type I [HTLV-I] in comparison with Khorasan Province, considering HTLV-I as an etiology of spastic paraparesia, it may be neglected in evaluation of spastic paraparesis in the other regions of Iran. Some reports of spastic paraparetic patients due to HTLV-I infection in West Azarbaijan, caused us to reconsider the importance of HTLV-I epidemiology in the other areas of the country. All spastic paraparetic patients who referred to Motahari and Imam Khomeini educational hospitals of Urmia from September 2004 to September 2007 were assessed for HTLV-I infection antibodies. In our 3 years study, 11 cases were diagnosed as Human T Lymphotropic Virus type I Associated Myelopathy/Tropical spastic Paraparesis [HAM/TSP, 2 males and 9 females]. The mean age of patients at the time of diagnosis was 45.8 years. Dorsal and cervical MRI of all patients was normal. Serum Enzyme-Linked Immuno-Sorbent Assay [ELISA] and Western blot [WB] for anti HTLV-I antibody in all patients was positive. Four patients underwent for lumber puncture in which were normal in respect of cells and biochemistry, but positive for anti-HLTLV-I antibodies. HAM/TSP detection in West Azarbaijan in spite of its long distance from Khorasan Province shows the importance of anti-HTLV-I Ab assay in the blood and CSF of every spastic paraparetic patient all over the country

Sero-epidemiological study on the human T-cell leukaemia virus type I/II infection in the east coastal areas of Fujian province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the seroprevalence of human T-cell leukaemia virus type I/II (HTLV-I/II) infection in adult population in the east coastal areas of Fujian and to explore the possible risk factors of HTLV-I/II.</p><p><b>METHODS</b>A total number of 3259 blood samples from drug users, sexually transmitted disease (STD) patients, prostitutes and blood donors for serologic assays during 1999 to 2002, were collected. All samples were screened for HTLV-I/II antibody, using enzyme linked immunosorbent assay (ELISA) kits. All of the positive samples were confirmed by western blot (WB) kits. Statistical analysis was done by Epi software, and chi(2) test by Fisher's exact test. P value < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>The overall seroprevalence rate of HTLV-I/II in healthy populations was 0.06% including, 0.32% in drug users, 0.58% in STD patients and prostitutes respectively. HTLV-II had not been found. The seropositive rates for HTLV-I in STD patients and prostitutes were significantly higher than the findings among healthy populations (P < 0.05). There were no different seroprevalence rates between drug users and healthy populations (P > 0.05). No significant changes in HTLV-I prevalence rates were found in the different age groups as well as in Fuzhou and Linde cities (P > 0.05).</p><p><b>CONCLUSION</b>The result suggested that in the east coastal areas of Fujian province, HTLV-I was the main prevalent virus. The seroprevalence of HTLV-I was very low, with no HTLV-II. Neither age nor gender seemed to be HTLV-I risk factor in the east coastal areas of Fujian province, but the increase of exposure to sex might be one.</p>

El gen tax del virus linfotrópico humano tipo I en la identificación etiológica de la paraparesia espástica tropical: estudio clínico, serológico y de polimerasa en cadena en 72 pacientes / HTLV-I tax gene on the etiological identification of tropical spastic paraparesis: a clinical, serological and polymerase chain reaction study in 72 patients

Background: Tropical spastic paraparesis (TSP) is an endemic disease in Chile. In most countries, only 50 percent of patients are seropositive to HTLV-I. However, new studies suggest that seronegative TSP is also associated with HTLV-I. Aim: To describe clinical and virological features of seronegative patients with TSP. Patients and methods: seventy two chilean patients with TSP, studied by clinical, radiological and laboratory methods during 1998, are reported. The determination of antibodies to HTLV-I was accomplished by ELISA, immunofluorescence and western-blot analysis. Polymerase chain reaction for tax and 5'Ltr genes was made using primers SK 43-44, LTR1 and LTR6. Results: Thirty one patients were HTLV-I positive and 41 were negative. No clinical, radiological or laboratory differences were observed between both groups. In seropositive patients, tax and 5'ltr viral gene sequences of the HTLV-I provirus were detected in DNA of peripheral blood mononuclear cells. In seronegative cases, sequences of tax gene were detected, exclusively, in 18 of 41 patients. Conclusions: These results confirm an association with HTLV-I infection in 43,9 percent of the TSP seronegative patients. These findings support the hypothesis that a defective provirus infects peripheral blood mononuclear cells in seronegative cases of TSP. The importance tax gene in the diagnosis of the TSP is also emphasized

HLA-DRB1 alleles in Egyptian children with steroid-sensitive nephrotic syndrome: association with outcome

To investigate whether polymorphic HLA-DRB1 alleles are significantly associated with outcome in Egyptian children with steroid-sensitive nephrotic syndrome [SSNS]. Cross-sectional study. Among attendants of Pediatric Nephrology Outpatient Clinic, 54 unrelated children with SSNS were enrolled. They included 32 males and 22 females, their ages ranged from 1.8 to 14 years. According to response to standardized prednisone therapy, patients were categorized into two different outcome groups: non-relapsing or Infrequently relapsing [NR/IR] group [n = 24], and Frequently relapsing [FR] group [n = 30]. Among FR patients, 24 were treated with alkylating agents, and according to their responses, they were categorized into two different outcome groups: active disease outcome group [n = 15] and long-term remission outcome group [n = 9]. HLA-DRB1 alleles typing was done using the DNA polymerase chain-reverse hybridization technique. The results of present study showed that: [I]. DRB101 alleles showed significant positive association with NR/IR outcome [relative risk [RR] = 45, 95% confidence interval [95% Cl] = 19.1-105.7, Phi-coefficient [delta = + 0.74, P<0.00001, correctedP [Pb] <0.001]; and significant negative association with FR outcome [RR = 0.03, 95% Cl = 0.01-0.09, delta = - 0.69, P <0.00001, Pb <0.001]; [II]. DRB10701/0301 alleles-heterozygosity showed significant positive association with FR outcome [RR = 72.25, 95% Cl = 30 -169.3, delta = + 0.89, P<0.00001, Pb <0.001]; and significant negative association with NR/IR group [RR = 0.01, 95% Cl = 0.004-0.02, delta = 0.93, P <0.00001, Pb <0.001]; [III]. DRB10701 allele showed significant positive association with active disease outcome after alkylating therapy [RR =111, 95% Cl = 47.2-260.8, delta = + 0.82, P <0.00001, Pb <0.001]; and significant negative association with long-term remission outcome [RR = 0.009, 95% Cl = 0.004-0.02, delta = - 0.82, P <0.00001, Pb <0.001]. The current data suggest that HLA-DRB1 alleles are significantly associated with outcome in Egyptian children with steroid-sensitive nephrotic syndrome. The present authors propose that new therapeutic trials in SSNS should take into account the HLA status of patients

Experimental HTLV-1 infection and associated myelopathy

HTLV-I infection and associated myelopathy has been reproduced experimentally in vitro and in vivo and these studies have shown the possibility of creating several lines of infective cells and of detecting minor and major clinical expressions of HTLV-I associated myelopathy in rabbits and rats.

HTLV-I associated myelopathy in Salvador (Northeastern Brazil)

Recentes estudos têm mostrado a presença de mielopatia associada a infecçäo por HTLV-I em muitas áreas tropicais do mundo. Com o objetivo de determinar o papel do HTLV-I como agente etiológico de mielopatias em Salvador, realizamos estudo clínico e sorológico em 43 pacientes com mielopatia de etiologia näo traumática e näo tumoral. Encontramos 9 pacientes com mielopatia associada a HTLV-I (HAM) o que sugere nova área endêmica de HAM