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Clinical profile of human T-lymphotropic virus type I: a forgotten infection in pediatrics / Perfil clínico del virus linfotrópico humano tipo I: una infección olvidada en pediatría
Mejía-Mertel, Juliana; Weill Center for Metabolic Health and Division of CardiologyGómez-Banoy, Nicolás; Department of PediatricsRojas-Hernández, Juan Pablo; Gotuzzo-Herencia, Eduardo.
  • Mejía-Mertel, Juliana; Libre University. Department of Pediatrics. Cali. CO
  • Weill Center for Metabolic Health and Division of CardiologyGómez-Banoy, Nicolás; Weill Cornell Medicine. Department of Medicine. Weill Center for Metabolic Health and Division of CardiologyGómez-Banoy, Nicolás. New York. US
  • Department of PediatricsRojas-Hernández, Juan Pablo; Club Noel Childrens Clinic Foundation. Division of Infectious Diseases. Department of PediatricsRojas-Hernández, Juan Pablo. Cali. CO
  • Gotuzzo-Herencia, Eduardo; Peruana Cayetano Heredia university. Division of Tropical and Infectious Diseases. Department of Internal Medicine. Lima. PE
Infectio ; 25(1): 28-32, ene.-mar. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1154398
ABSTRACT
Summary The Human T-lymphotropic virus type 1 (HTLV-1), a retrovirus with oncogenic properties, affects around ten to twenty million people worldwide. The most common disorders associated with HTLV-1 infection are T-cell leukemia/lymphoma (ALT) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Studies have reported other clinical manifestations in HTLV-1 seropositive patients, including inflammatory disorders, co-infections with opportunistic agents, and pulmonary diseases.

Objective:

Here, we aim to describe a cohort of juvenile patients with confirmed HTLV-1 infection that showed clinical manifestations other than neurological symptoms. Methodology and patients Retrospective analysis of clinical data describing background and clinical findings of 12 juvenile patients with confirmed HTLV-1 infection, attended during January 2018 to February 2020 in a pediatric referral hospital in Cali, Colombia.

Results:

11 out 12 patients were from Colombia´s Pacific coast, 10 suffered from significant nutritional deficiencies. Six exhibited dermatological findings, 3 compatible with infective dermatitis. None of the cases exhibited clinical or laboratory findings suggesting ALT or HAM/TPS. Eight patients had structural lung disease assessed by chest Computed Tomography (CT) scans; 4 of them tested positive for galactomannan antigen in bronchoalveolar fluid suggesting pulmonary aspergillosis, and 2 others exhibited a positive PCR testing for tuberculosis. Three patients were diagnosed with autoimmune disorders; 1 patient with Crohn´s Diseases, 1 case of autoimmune thrombocytopenic purpura, and a patient with Vogt-Koyanagi-Harada syndrome (non-granulomatous uveitis).

Conclusions:

There is a broad range of clinical manifestations in pediatric HTLV-1 patients, and the clinician should consider structural pulmonary disease, opportunistic co-infections and autoimmune disorders in the diagnostic algorithm.
RESUMEN
Resumen El Virus Linfotrópico de células T humanas tipo 1 (HTLV-1), retrovirus con propiedades oncogénicas, afecta alrededor de 10-20 millones de personas mundialmente. Las manifestaciónes más comúnmente asociadas a HTLV-1 incluyen leucemia/linfoma de células T (ALT) y mielopatía asociada a HTLV-1/ paraparesia espástica tropical (HAM/TSP). Estudios han reportado otras manifestaciones clínicas en pacientes positivos para HTLV-1, incluyendo enfermedades inflamatorias, coinfecciones con gérmenes oportunistas y enfermedad pulmonar.

Objetivo:

es describir clínicamente una cohorte de pacientes pediátricos con infección por HTLV-1 confirmada que presentan manifestaciones clínicas diferentes a síntomas neurológicos. Metogolodía y pacientes Análisis retrospectivo de historia clínica describiendo procedencia y hallazgos clínicos en 12 pacientes con infección por HTLV-1 confirmada, atendidos durante el periodo de Enero de 2018 a Febrero de 2020 en un hospital pediátrico de referencia en Cali, Colombia.

Resultados:

Once de 12 pacientes procedían de la costa Pacífica Colombiana, 10 con deficiencias nutricionales significativas. Seis mostraron compromiso dermatológico, 3 compatibles con dermatitis infectiva. Ningún paciente presentó hallazgos clínicos o paraclínicos sugestivos de ALT o HAM/TPS. Ocho pacientes presentaron enfermedad pulmonar estructural evidenciada por TAC de tórax; 4 de ellos con antígeno galactomanan positivo en lavado broncoalveolar, sugiriendo aspergilosis pulmonar, y otros 2 resultaron con PCR positiva para tuberculosis. Tres pacientes presentaron enfermedades autoinmunes concomitantes uno con Enfermedad de Crohn, uno con Púrpura Trombocitopénica Autoinmune, y un paciente con Síndrome de Vogt-Koyanagi-Harada.

Conclusiones:

Existe un amplio rango de manifestaciones clínicas en pacientes pediátricos con HTLV-1, considerando enfermedad pulmonar estructural, coinfecciones oportunistas y enfermedades autoinmunes dentro del algoritmo diagnóstico.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Viruses / Human T-lymphotropic virus 1 / Infections Limits: Adolescent / Child / Child, preschool / Humans / Infant Language: English Journal: Infectio Journal subject: Communicable Diseases Year: 2021 Type: Article Affiliation country: Colombia / Peru / United States Institution/Affiliation country: Club Noel Childrens Clinic Foundation/CO / Libre University/CO / Peruana Cayetano Heredia university/PE / Weill Cornell Medicine/US

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Full text: Available Index: LILACS (Americas) Main subject: Viruses / Human T-lymphotropic virus 1 / Infections Limits: Adolescent / Child / Child, preschool / Humans / Infant Language: English Journal: Infectio Journal subject: Communicable Diseases Year: 2021 Type: Article Affiliation country: Colombia / Peru / United States Institution/Affiliation country: Club Noel Childrens Clinic Foundation/CO / Libre University/CO / Peruana Cayetano Heredia university/PE / Weill Cornell Medicine/US