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Biomedical subjects

L Cartier

Publications and source records attributed to L Cartier.

At least 55 records · Page 3Linked to original sources

[Effect of the Nucleus CMP forte in 46 patients with progressive spastic paraparesis. Randomized and blind study].

BACKGROUND: Idiopatic or HTLV-1 associated progressive spastic paraparesis does not have a clear etiology or treatment. AIM: To assess the effects of a medication containing cytidinmonophosphate, uridintriphosphate and vitamin B 12 in the treatment of progressive spastic. PATIENTS AND METHODS: Patients with the disease were randomly assigned to receive the Nucleus CMP forte (containing dysodic cytidinmonophosphate 5 mg, trisodic uridintriphosphate 3 mg and hydroxicobalamin 2 Mg) tid or placebo during six months. Gait, spasticity, degree of neurogenic bladder and somatosensitive evoked potentials were assessed during treatment. RESULTS: Forty six patients aged 25 to 79 years old were studied, 24 were female and 29 HTLV-1 positive. Twenty two were treated with the drug and the rest with placebo. Gait and spasticity improved in 7 of 22 patients receiving the drug and 1 of 24 receiving placebo (p < 0.05). Neurogenic bladder improved in 10 of 22 receiving the drug and 4 of 24 receiving placebo (NS) Somatosensitive evoked potentials improved in four of seven patients treated with the drug and in two of seven treated with placebo. CONCLUSIONS: The medication caused a modest improvement in patients with progressive spastic paraparesis and was free of side effects.

Adult↗

[Primary polymyositis associated to HTLV-I].

We report a 68 years old male with a polymyositis associated to HTLV-I. Diagnosis was based on clinical picture, an increased creatin-phosphokinase levels, electromyography and muscle biopsy. The patient had positive HTLV-I antibodies, measured by particle agglutination test, indirect immunofluorescence and polymerase chain reaction in lymphocytes. Skin biopsy showed a mycosis fungoides. Schirmer test and minor salivary gland biopsy showed a dacryosialoadenitis. There was no central nervous system involvement. This patient is the only with positive HTLV-I antibodies, among 18 patients with polymyositis in whom these antibodies were measured.

Aged↗

[Late centronuclear myopathy: autosomal dominant form].

We report a family with three generations affected by an autosomal dominant centronuclear palsy. This gene is characterized by ptosis that begins in childhood and a slowly progressive weakness that starts in the second decade of life, involving face, neck and limbs. In this stage, muscle pan associated to exercise or cold muscle spasms may appear. The gene is expressed with differing intensity in each individual. Myopathic electromyographic alterations are only found in functionally impaired subjects. Muscle biopsy shows type I fiber atrophy and central nuclei in a high percentage of fibers, specially in type I fibers.

Adolescent↗

Ethnic segregation of HTLV-I and HTLV-II carriers among South American native Indians.

To investigate the genetic background of human T-cell leukemia virus type I (HTLV-I) and II (HTLV-II) carriers among South American native Indians, we analyzed HLA DRB1*-DQB1* haplotypes of the virus carriers from Andes highlands and Orinoco lowlands by the PCR-RFLP genotyping method. It was revealed that the HTLV-I-carrying Andes natives had one of the 5 HLA haplotypes: DRB1*-DQB1* 0403-0302, 0802-0402, 0901-0303, 1406-0302 and 0407-0302, and that the Orinoco HTLV-II carriers had one of the 3 HLA haplotypes: DRB1*-DQB1* 1402-0301, 1602-0301 and 0404-0302. The HLA haplotypes of Andes HTLV-I carriers and Orinoco HTLV-II carriers were mutually exclusive. The haplotypes associated with HTLV-I carriers were commonly found among the Andes Indians and Japanese, which is the known HTLV-I endemic population, while the haplotypes associated with HTLV-II carriers were specifically found among the Orinoco Indians and North American Indians, among whom HTLV-II is endemic. These results suggested that HLA haplotypes might be ethnically segregated among South American natives and might be involved in the susceptibility to HTLV-I and HTLV-II infections.

Alleles↗

A search for human T-cell leukemia virus type I in the lesions of patients with tropical spastic paraparesis and polymyositis.

We searched for the presence of human T-cell leukemia virus type I (HTLV-I) sequences in central nervous system and muscle lesions of 3 patients with tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM) and 3 patients with HTLV-I-associated polymyositis. Proviral DNA coding for the Tax protein was found by polymerase chain reaction amplification in DNA extracted from lesions of every patient with TSP/HAM or HTLV-I-associated polymyositis. In contrast, viral RNA was found occasionally by in situ hybridization in muscle lesions of some patients with polymyositis, but was never found in central nervous system lesions of TSP/HAM patients.

DNA, Viral↗

Chronic dacryosialadenitis in HTLV I associated myelopathy.

A prospective study was carried out on 48 patients with HTLV I associated myelopathy/tropical spastic paraparesis (HAM/TSP) to assess the association between this entity and Sjögren's syndrome. Fourteen patients (29.1%) had chronic dacryosialadenitis confirmed by a positive Schirmer's test and salivary gland biopsy. None of these patients had evidence of collagen disease and tests for Ro, La, and rheumatoid factor were negative except in one case. Therefore, the dacryosialadenitis could not be classified as either primary or secondary Sjögren's syndrome. Ten of the 14 patients (71.4%) had other systems (haematological, articular, dermatological, or respiratory) involved apart from the neurological and exocrine gland pathology. The findings suggest that the dacryosialadenitis associated with HTLV I is a disease of viral origin distinct from Sjögren's syndrome.

Adult↗

Epidemiological features of HTLV-I and adult T cell leukemia.

Adult T-cell leukemia (ATL) patients and human T-cell leukemia virus type I (HTLV-I) carriers are clustered in limited groups in the world, especially among Japanese in Asia, Blacks in Central Africa, Melanesians in Papua New Guinea and Andeans in South America. The major transmission routes of HTLV-I under natural conditions are from mother-to-child through breast milk and from man-to-woman through semen. The whole life risk of ATL among persistent HTLV-I carriers is estimated at 2-6%. The detailed manifestation mechanism of ATL is not yet clarified; however, it is certain that HTLV-I infection in infancy is the main cause of ATL. Therefore, the prevention measure against mother-to-child transmission of HTLV-I is indispensable from a viewpoint of public health.

Adult↗

HTLV-I positive progressive spastic paraparesis (TSP) associated with a lymphoid disorder in three Chilean patients.

We describe the clinical and laboratory features in three Caucasian Chilean patients with tropical spastic paraparesis (TSP) associated with/or preceded by a lymphoproliferative disorder involving cutaneous lesions and localised lymphadenopathy. The neurological symptoms and signs were characteristic of TSP and CSF examination revealed the presence of oligoclonal bands. All three patients had a moderate leucocytosis (10-14 x 10(9)/l) with eosinophilia and a minority (2-4%) of circulating atypical polylobed or ATLL-like lymphocytes. Lymph node histology showed a diffuse pattern of infiltration (1 case) and marked expansion of the paracortical zone with convoluted lymphocytes and immunoblasts (2 cases). Skin biopsy demonstrated a dermal lymphoid infiltration with epidermotropism. Antibodies to HTLV-I were detected in the serum and CSF in the three patients and Southern blot analysis of peripheral blood mononuclear cells showed a monoclonal integration of HTLV-I proviral DNA in one case whereas in the two others the pattern was indicative of low level polyclonal integration. All three patients were treated with prednisolone and one with PUVA with transient partial response on the skin and neurological manifestations. Two patients died months to 5 years from presentation and the other is alive 12 years from diagnosis with active neurological and skin disease. The simultaneous occurrence of HTLV-I associated TSP with smouldering ATLL and a cutaneous ATLL or pre-leukaemic form is discussed.

Adult↗

[Seroprevalence of HTLV-I in relatives of patients with spastic paraparesis (HAM/TSP and PEP)].

The seroprevalence of HTLV-1 was studied in parents, brothers, siblings and sexual partners of 147 patients with spastic paraparesis associated to HTLV-1 (HAM/TSP) and 84 patients with HTLV-1 negative spastic paraparesis (SP). Seroprevalence was 29.1% for HAM/SP and 0% for SP relatives (p < 0.001); the last figure is similar to that of the general population. Seroprevalence in sexual partners was 65%, suggesting that sexual intercourse is the principal route of transmission. Likewise, seroprevalence in siblings of mothers with HAM/TSP or HTLV-1 positive was 17.6%, suggesting a high maternal transmission.

Adolescent↗

[Quadriceps myopathy: a type of late focal dystrophy in a case].

A 62 years old male with a slowly progressive focal myopathy is presented. He had noticed weakness in the lower limbs for three years and weakness in the upper limbs for one year. He had bilateral atrophy of quadriceps and biceps muscles, absence of knee jerks and hypertrophy of the calves. Needle EMG showed myopathic motor units. Hystological study was compatible with muscular dystrophy. The clinical and laboratory characteristics of this patient are in keeping with what has been described as "Quadriceps Myopathy" as a form of a muscular dystrophy.

Biopsy↗

[Myopathy caused by acid maltase deficiency in an adult].

We report a 46 years old male presenting with tetraparesis and severe respiratory involvement. He had moderately elevated serum creatine phosphokinase values and the electromyography showed myopathic alterations and irritative signs. In the muscle biopsy, a vacuolar myopathy with increased collagen deposits was found. Circulating lymphocytes presented abnormal PAS positive granules in their cytoplasm.

Creatine Kinase↗

[Anti HTLV-I antibody titers in seropositive infected individuals].

The aim of this study was to determine anti HTLV-I antibody titers in seropositive symptomatic and asymptomatic infected subjects. One hundred seven infected subjects (47 with spastic paraparesis and 60 asymptomatic) were studied. HTLV-I antibodies were determined using indirect immunofluorescence in cells infected with the retrovirus. The mean titer was 1/234 in asymptomatic subjects and 1/2138 in symptomatic patients (p < 0.001). These results suggest an association between HTLV-I antibody titers and clinical stage of infected subjects.

Adult↗

Southernmost carriers of HTLV-I/II in the world.

To clarify the real distribution of HTLV-I and -II carriers among indigenous people in central and South America, blood samples collected from indigenous people in isolated regions of Southern Chile were examined. Among 199 inhabitants from Chiloe Island and Pitrufquen town, three cases (1.5%) showed positive anti-HTLV-I antibodies. Two out of the three (82-year-old male and 58-year-old female) reacted to HTLV-II-specific Gag and/or Env proteins but not to HTLV-I-specific ones. The latter case was confirmed as an HTLV-II carrier by polymerase chain reaction test.

Aged↗

[Cerebral abscess caused by Toxoplasma gondii and AIDS. Report of a case with anatomo-pathological study].

We report a 47 year old woman that presented to the hospital with an intracranial hypertension syndrome, a right hemiparesis and a several months history of progressive malaise and behavioral disturbances. During the hospital stay, positive HIV antibodies were detected and CAT scan showed a profound left parietal rounded hypodense lesion. The patient died 21 days after admission and the postmortem pathological study showed a deep abscess in the left basal ganglia, with recognizable Toxoplasma gondii trophozoites.

Acquired Immunodeficiency Syndrome↗

[Preliminary study of HTLV-I seroprevalence in Chilean Indian populations].

Aiming to seek the origin and define the prevalence of HTLV-1 infections, 464 blood samples from aboriginal populations proceeding from isolated regions of the north and south of Chile were studied. Antibodies against HTLV were measured with agglutination tests and confirmed with immuno-fluorescence and Western Blotting. Seven out of 107 (6.5%) blood samples from Atacama indians, 2 out of 202 (1%) from Mapuche indians and 3 out of 155 (1.9%) from Huilliche aborigines were positive. These results highlight an important presence of the virus in indigenous populations, specially in the extremes of the country. These findings could suggest an indigenous (mongoloid) origin of HTLV-1 in Chile, specially in Chiloe, where apparently there has been no contact with african or japanese populations, that could be the origin of the contamination.

Adolescent↗

Familial Creutzfeldt-Jakob disease in Chile is associated with the codon 200 mutation of the PRNP amyloid precursor gene on chromosome 20.

We have found the codon 200Lys mutation in 6 Chilean CJD families, including a family in the rural case cluster in Chillán. Thus, all 3 of the known clusters of CJD, in Slovakia, Libyan-born Israeli Jews, and Chile, are linked to the presence of the same mutation. The phenotypic features of the disease in these families are similar to those reported for other clustered or individual families elsewhere in the world. The heterogeneous genetic composition of the Chilean population interpreted in light of historical migration patterns suggests that the mutation may have entered Chile by Jewish emigration from Spain.

Adult↗

Progressive spastic paraparesis associated with human T-cell leukemia virus type I (HTLV-I).

Patients with progressive spastic paraparesis (PSP), commonly middle-aged women, are distributed throughout the country of Chile. During the three years from 1987 to 1990, we collected 83 cases of PSP from among 225 patients with various neurological diseases. The clinical picture was of a bilateral pyramidal syndrome, with sensory deficits in only 15.5% of the cases, and a slow illness progression in the majority of them. In patients with PSP, antibody to human T-cell leukemia virus type I (HTLV-I) was analyzed by enzyme linked immunosorbent assay (ELISA) and confirmed by western blot analysis. Forty-five (54.2%) patients were anti-HTLV-I antibody positive in cerebrospinal fluid (CSF) and peripheral blood. Among them, 2 patients had leukemia/lymphoma and one had Sjögren syndrome. In the laboratory study of seropositive PSP, mononuclear pleocytosis was found in 35.7%; there was an abnormal increase of the IgG index in 66.6% and an increase in CD2 in blood and CSF, and CD4 in blood. A delayed latency of somatosensory evoked potentials was observed in 90.9%. The neuropsychological study revealed a WAIS with a mean verbal IQ of 80.7 and a mean performance IQ of 84.8. The most impaired items were digit symbol and digit span. Seven subjects (18.9%) with anti-HTLV-I antibody were found among 37 relatives from 19 anti-HTLV-I positive cases of PSP.

Adult↗

[HTLV-I clinical pathological spectrum].

HTLV-I has been revealed as the etiological factor of the Tropical Spastic Paraparesis (TSP) and of the T-cell leukemia-lymphoma of the adult (ATLL). Recently, it has also been associated to some forms of polymyositis, polyarthritis, polyneuropathies, Sjögren's syndrome, thrombocytopenia and lympho-alveolitis. The clinical and pathological spectrum of this retrovirus is analyzed taking into account the Chilean cases and those reported by the international medical literature.

Arthritis, Infectious↗