tropical spastic paraparesis

Some of the signs of Tropical spastic paraparesis are:

File:Polymyositis HE.jpg

:::::::*Leg instability

:::::::*Urinary dysfunction.

:::::::*Bowel dysfunction

:::::::*Back pain

:::::::*Erectile problems

:::::::*Psoriasis

Individuals with 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).{{Cite book |last=Clarke |first=Charles |url=https://books.google.com/books?id=0BpFs2KlnH4C&q=Tropical%2520spastic%2520paraparesis%2520%2520%2520uveitis%252C%2520arthritis%252Cpulmonary%2520lymphocytic%2520alveolitis%2520%2520%2520polymyositis%2520%2520%2520polymyositis%2520%2520%2520%2520%2520%2520%2520keratoconjunctivitis%2520sicca%2520%2520%2520%2520%2520%2520%2520infectious%2520dermatitis&pg=PT984 |title=Neurology: A Queen Square Textbook |last2=Howard |first2=Robin |last3=Rossor |first3=Martin |author-link3=Martin Rossor |last4=Shorvon |first4=Simon D. |date=2011-09-09 |publisher=John Wiley & Sons |isbn=9781444356359 |access-date=2020-11-07 |archive-url=https://web.archive.org/web/20230111173709/https://books.google.com/books?id=0BpFs2KlnH4C&q=Tropical%2520spastic%2520paraparesis%2520%2520%2520uveitis%252C%2520arthritis%252Cpulmonary%2520lymphocytic%2520alveolitis%2520%2520%2520polymyositis%2520%2520%2520polymyositis%2520%2520%2520%2520%2520%2520%2520keratoconjunctivitis%2520sicca%2520%2520%2520%2520%2520%2520%2520infectious%2520dermatitis&pg=PT984 |archive-date=2023-01-11 |url-status=live}}

HTLV-1 can be transmitted via breastfeeding (mother to child), sexual contact, via blood contact (transfusion or needle sharing).{{Cite web |title=HTLV-1 associated myelopathy/tropical spastic paraparesis {{!}} Disease {{!}} Overview {{!}} Office of Rare Diseases Research (ORDR-NCATS) |url=https://rarediseases.info.nih.gov/gard/8208/htlv-1-associated-myelopathytropical-spastic-paraparesis/resources/1#Basic%2520Information |url-status=dead |archive-url=https://web.archive.org/web/20150905112257/https://rarediseases.info.nih.gov/gard/8208/htlv-1-associated-myelopathytropical-spastic-paraparesis/resources/1#Basic%2520Information |archive-date=2015-09-05 |access-date=2015-08-13 |website=rarediseases.info.nih.gov}}

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In tropical spastic paraparesis, HTLV-1 shows elevated cellular acquired immune response as well as high production of proinflammatory cytokines. Interferon overexpression has been demonstrated as well. Also the number of NK cells (CD56+ and CD16+) is diminished.{{Cite journal |last=Yamano |first=Yoshihisa |last2=Sato |first2=Tomoo |year=2012 |title=Clinical Pathophysiology of Human T-Lymphotropic Virus-Type 1-Associated Myelopathy/Tropical Spastic Paraparesis |journal=Frontiers in Microbiology |volume=3 |pages=389 |doi=10.3389/fmicb.2012.00389 |pmc=3494083 |pmid=23162542 |doi-access=free}}

Among the methods of diagnosing tropical spastic paraparesis are MRI (magnetic resonance imaging) and lumbar puncture (which may show lymphocytosis).{{Cite web |title=Tropical Spastic Paraparesis. About TSP medical condition {{!}} Patient |url=http://patient.info/doctor/tropical-spastic-paraparesis |url-status=live |archive-url=https://web.archive.org/web/20171129083839/https://patient.info/doctor/tropical-spastic-paraparesis |archive-date=29 November 2017 |access-date=24 July 2016 |website=Patient}}

Often, the diagnosis process is based on symptoms and one's risk of exposure to the virus. A spinal tap or lumbar puncture may be used to obtain blood and CSF samples which can then be tested for parts of the virus or antibodies produced to combat the virus. MRI may be performed on the brain and spinal cord to check for abnormalities such as spinal cord degeneration and other potential causes of symptoms.{{Cite web |title=HTLV-1–Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) |url=https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/spinal-cord-disorders/tropical-spastic-paraparesis-htlv-1-associated-myelopathy-tsp-ham |url-status=live |archive-url=https://web.archive.org/web/20230228182435/https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/spinal-cord-disorders/tropical-spastic-paraparesis-htlv-1-associated-myelopathy-tsp-ham |archive-date=28 February 2023 |access-date=28 February 2023 |website=Merck Manual Consumer Version}}

File:Immunoglobulin.png

Treatment of TSP involves corticosteroids to help with inflammation. However, any success with corticosteroids is short-lived, with symptoms worsening as the dosage is reduced. A synthetic derivative, 17-alpha-ethinyltestosterone, can be used to treat tropical spastic paraparesis, improvement in motor and bladder function was reported but not sustainable.{{Cite journal |last=Ali |first=A |year=2006 |title=Tropical spastic paraparesis and polymyositis: a still unfolding story |journal=West Indian Medical Journal |volume=55 |issue=6 |pages=459–63 |doi=10.1590/S0043-31442006000600023 |pmid=17691249 |doi-access=free}}

Mogamulizumab, an anti-CCR4 IgG1 monoclonal antibody, is also being researched as a possible treatment for tropical spastic paraparesis. The antibody reduces HTLV-1 proviral load and production of proinflammatory cytokines. Valproic acid has also succeeded in reducing the proviral load of HTLV-1 (though clinical benefits were minimal or none). A further combination of valproic acid and zidovudine has demonstrated a decrease in proviral loads (in animals).{{EMedicine|article|219285|Human T-Cell Lymphotropic Viruses|treatment}}

The prognosis for tropical spastic paraparesis indicates some improvement in a percentage of cases due to immunosuppressive treatment. A higher percentage will eventually lose the ability to walk within a ten-year interval.{{Cite book |last=Prayson |first=Richard A. |url=https://books.google.com/books?id=DmNSdcu14HEC&q=tropical%2520spastic%2520paraparesis%2520prognosis&pg=PA359 |title=Neuropathology |date=2011-11-15 |publisher=Elsevier Health Sciences |isbn=978-1437709490 |access-date=2020-11-07 |archive-url=https://web.archive.org/web/20230111174129/https://books.google.com/books?id=DmNSdcu14HEC&q=tropical%2520spastic%2520paraparesis%2520prognosis&pg=PA359 |archive-date=2023-01-11 |url-status=live}}

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).{{medical citation needed|date=August 2015}}

Tropical myeloneuropathies are classified as two separate syndromes: tropical ataxic neuropathy (TAN) and tropical spastic paraparesis (TSP). They are placed together because they are found in tropical countries, although tropical spastic paraparesis

has occurred in temperate countries (e.g., Japan).{{EMedicine|article|1166055|Tropical Myeloneuropathies}}

• Treponema pallidum
• Myelopathy
• Lymphatic system
• Neuropathy

{{Reflist}}

• {{Cite journal |last=Machigashira |first=N. |last2=Yoshida |first2=Y. |last3=Wang |first3=S.-y. |last4=Osame |first4=M. |year=2001 |title=HTLV-1-associated myelopathy/tropical spastic paraparesis with pseudohypoparathyroidism |journal=Neurology |volume=56 |issue=1 |pages=104–6 |doi=10.1212/WNL.56.1.104 |pmid=11148245 |doi-access=free}}
• {{Cite journal |last=Nagamine |first=Yuito |last2=Hayashi |first2=Takeshi |last3=Kato |first3=Yuji |last4=Horiuchi |first4=Yohsuke |last5=Tanahashi |first5=Norio |year=2015 |title=Human T Lymphotropic Virus Type-1-associated Myelopathy Manifesting Shortly after Living-donor Renal Transplantation |journal=Internal Medicine |volume=54 |issue=1 |pages=75–8 |doi=10.2169/internalmedicine.54.2950 |pmid=25742898 |doi-access=free}}

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{{Commons}}

{{Scholia|topic}}

{{Spinal cord lesions}}

{{Viral diseases}}

{{DEFAULTSORT:Tropical Spastic Paraparesis}}

Category:Viral diseases