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Module 2 > HTLV-1 and Inflammation > Flashcards

HTLV-1 and Inflammation Flashcards

1
Q

How many HTLV-1 carriers get HAM?

A

> 3%

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2
Q

What is seen with HTLV-1 assocaited alveolitis?

A

cough and dyspnoea or asymtpomatic

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3
Q

Waht condition is associated with htlv1-associated alevolitis?

A

HAM

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4
Q

What is seen on BAL with HTLV1-associated alveolitis?

A

lymphocytosis of activated lymphocytes- CD25 and HLA DR markers

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5
Q

Which type of joints does HTLV-1 assocaited arthropathy affect?

A

large joints

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6
Q

Which gender is more affected by HTLV1 associated arthropathy?

A

femal

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7
Q

What is seen histoogically with HTLV-1 associated arthropathy?

A

synovial proliferation with lymphocytes; HTLV-1 antibodies and flower clels in synovial fluid

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8
Q

Who gets infective dermatits?

A

children in the tropics

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9
Q

What does infective dermatitis resemble?

A

infected eczema eithout atopy

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10
Q

What is infective dermatitis associated with?

A

high proviral load and increased risk of HAM or ATLL

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11
Q

What organisms cause infective dermaittis?

A

non-pathogenic strep and staph

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12
Q

Where does infective dermatits affect?

A

scalp, ears, axillae, groins

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13
Q

What is the treatment for infective dermatitis?

A

long term antibiotics

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14
Q

What are hte clinical features of HTLV-1 associated myositis?

A

proximal muscle weakness; wasting; elevated CPK; associated with HAM

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15
Q

Which patients get HTLV-1 assocaited myositis?

A

very rare- all patients have high proviral load

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16
Q

What is seen histologically with myositis?

A

looks like an inclusion body myositis, lyphocytic infiltration of muscle

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17
Q

What lung diseases are seen with HTLV1?

A

alveolitis and bronchiectasis

18
Q

How much does the 10m timed walk deteriorate by per annum with HAM?

A

4 seconds

19
Q

How does HAM prgress

A

slowly

20
Q

What is seen on MR imaging in HAM?

A

very atrophic- loss of volume

21
Q

What is HTLV1 assocaited bronchiectasis assocaited with?

A

HTLV1 associated inflammatory disease but not ATLL

22
Q

Which area of the body is initially spared in HAM?

A

upper limbs and sensory

23
Q

What does the leg pain in HAM resemble?

A

sciatica

24
Q

What is seen histologically with HAM?

A

lymphocytic infiltration initially CD4>CD8 than CD8 predominante and then atrophy

25
Q

What is a biomarker of HAM and its severity?

A

beta2 microglobulin

26
Q

What is the difference between the CD4 and CD8 cells seen in HAM compared with otehr neurological disease?

A

the ratio isn’t different but CD4 DR+ and CD8 DR+ increased- high levels of T cell acitvation

27
Q

What is a disease assocaited with HTLV1 in the eyes?

A

uveitis

28
Q

When do patients with HTLV1 set their proviral load?

A

around 4 months after infection

29
Q

What is the general proviral load of most asymptomatic carriers of HTLV1?

A

within 1%

30
Q

Where does the proviral load of patients with HAM cluster?

A

around 10%

31
Q

Over what proviral load does the irsk of HAM increase?

A

> 1%

32
Q

How many asymptomatic carriers have a high PVL?

A

50%

33
Q

What is the risk of HAM if PVL>1%?

A

6%

34
Q

Why is B2M a useful biomarker?

A

it can be used to differentiate between HAM and other neuro disease; and differentiates between patients with a high PVL and hAM

35
Q

What happens to T cell activation as PVL increases?

A

increases as well

36
Q

What happens to T cell activation in HAM compared with high PVL?

A

increased in HAM

37
Q

What are the markers used to identify patients iwth HAM?

A

HTLV-1 PVL; CD4/CD25; CD4/HLADR; CD8/HLA-DR; B2 microglobulin

38
Q

How successful are the markers used for identifying HAM?

A

idetndies 90% of HAM patients but also 6% of AC that have HAM-like phenotype

39
Q

What is expressed in macrophages and microglia in neuroinflammation?

A

translocator protein (TSPO)

40
Q

What is TSPO used for?

A

PET imaging to investigate disease invovling microglial activation and/or macrophage recruitment

41
Q

How did TPSO uptake correlate with HAM disease?

A

with clinical severity and T cell activation markers

42
Q

Where is there especially high uptake of TPSO in HAM patients?

A

brainstem and thalamus

Module 2 (38 decks)

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