جستجوی مقالات مرتبط با کلیدواژه « ویروس لنفوسیتیک t انسانی نوع 1 » در نشریات گروه « پزشکی »

Human T-Lymphotropic Virus Type 1–Associated Myelopathy، or Tropical Spastic Paraparesis (HAM/TSP) is a slowly progressive disease with characteristics such as spastic paralysis، sensory dysfunction in lower limbs and sphincteric dysfunction which infection with HTLV-1 virus is responsible for it. Clinical course of this disease is almost progressive and without treatment results in severe disability. Human T Lymphocytic Virus-type 1 which is endemic in north east of Iran، Khorasan، in 3% of carriers results in HTLV-1 Associated Myelopathy /Tropical Spastic Paraparesis. Although chronic inflammation of spinal cord seems to play a major role in the pathogenesis of this disease، immunomodulatory treatments have not shown significant improvement in this disorder. Since، different approaches such as prednisolone، danazol، plasma exchange and alfa interferon are used for treatment of this disease، although، these treatments were not completely successful and one distinct protocol was not proposed. As HTLV-1 infection is endemic in Khorasan، clinical studies about this disorder and its treatment is necessary.

Human T Lymphocytic Virus-type 1، in 3% of carriers causes HTLV-1 Associated Myelopathy /Tropical Spastic Paraparesis. Detrusor overactivity is the most common urodynamic finding. In this study the use of botulinum-A toxin injections into the detrusor، as an alternative approach in patients with HTLV1 related detrusor overactivity who are resistant to anticholinergic therapy or with side effects of the medication، was introduced. A total of 25 patients with HTLV1 infection and suffering from severe signs of overactive bladder who were resistant to conservative and medical treatment، had been included in this study. Urodynamic study were done، then 300 IU of botulinum toxin type A was injected into the detrusor. The reassessment and follow up were performed with urodynamic study 3 months later. Overall 20 patients (80%) had high Maximum Detrusor pressure، higher than normal and after the injection reduced to 4 patients (16%) (p< 0. 001). From them، 2 patients had urinary leakage during cystometry،19 patients (76%) had Uninhibited bladder contractions and after the intervention decreased to 5 patients (20%) (p< 0. 001) and from them، 2 patients had urinary leakage during cystometry. Injection of botulinum neurotoxin type A showed to be effective in patients with HTLV-1 related bladder overactivity، according to the improvement of urodynamic study parametres. This treatment can have a major impact on future management of patients with resistance to anticholinergic therapy or with side effects of this medication.