CT Chest and pulmonary functional changes in patients with HTLV-associated myelopathy in the Eastern Brazilian Amazon

Luiz Fábio Magno Falcão, Aline Semblano Carreira Falcão, Rita Catarina Medeiros Sousa, Waldônio de Brito Vieira, Robson Tadachi Moraes de Oliveira, Valéria Marques Ferreira Normando, George Alberto da Silva Dias, Marcio Clementino de Souza Santos, Rodrigo Santiago Barbosa Rocha, Gilberto Toshimitsu Yoshikawa, Roberta Vilela Lopes Koyama, Satomi Fujihara, Víctor Augusto Cavaleiro Corrêa, Hellen Thais Fuzii, Juarez Antônio Simões Quaresma, Luiz Fábio Magno Falcão, Aline Semblano Carreira Falcão, Rita Catarina Medeiros Sousa, Waldônio de Brito Vieira, Robson Tadachi Moraes de Oliveira, Valéria Marques Ferreira Normando, George Alberto da Silva Dias, Marcio Clementino de Souza Santos, Rodrigo Santiago Barbosa Rocha, Gilberto Toshimitsu Yoshikawa, Roberta Vilela Lopes Koyama, Satomi Fujihara, Víctor Augusto Cavaleiro Corrêa, Hellen Thais Fuzii, Juarez Antônio Simões Quaresma

Abstract

The aim of this study was to compare computed tomography (CT) scans of chest and lung function among patients with Human T-Lymphotropic Virus Type 1 (HTLV) with and without HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). In this cross-sectional study performed between January 2013 and June 2016, we included 48 patients with HAM/TSP (19 women and 11 men) and without HAM/TSP (12 women and 6 men). We compared CT findings and lung functions of these groups. Patients who had HAM/TSP had abnormal CT findings (P = 0.000), including more frequent bronchiectasis (P = 0.049), parenchymal bands (P = 0.007), interlobular septal thickening (P = 0.035), and pleural thickening (P = 0.009). In addition, neither patients with HAM/TSP (9/30; 30%) nor the controls (0/18; 0%) had obstructive or restrictive lung disease (P = 0.009). HTLV diagnosis should be considered in all patients with abnormal CT findings in whom no other cause is apparent. It is important to remember that lung disease increases the rates of morbidity and mortality in developing countries.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Study flow chart.
Fig 1. Study flow chart.
This flow chart describes the selection of study patients.
Fig 2. Transverse CT scans obtained from…
Fig 2. Transverse CT scans obtained from two women aged 60 and 47 years, respectively, suffering from HAM/TSP.
a) Bronchiectasis signet ring appearance (white arrows) and ground-glass opacity (black arrows) b) ground-glass opacity (white arrow) and a pulmonary cyst in the right lower lobe (black arrows).
Fig 3. Transverse CT scans of a…
Fig 3. Transverse CT scans of a 59-year-old man and a 25-year-old woman with HAM/TSP.
a) Pleural thickening (white arrows) and bronchiectasis (arrowheads), bilaterally b) bilateral mosaic attenuation.

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