TY - JOUR T1 - Rapid development of subacute myelopathy in three organ transplant recipients after transmission of human T-cell lymphotropic virus type I from a single donor JF - Transplantation Y1 - 2003 A1 - Toro,C. A1 - Rodes,B. A1 - Poveda,E. A1 - Soriano,V. KW - *Tissue Donors KW - Adult KW - Base Sequence KW - Female KW - HTLV-I Infections / *transmission / virology KW - Human T-lymphotropic virus 1 / classification / isolation & purification KW - Humans KW - Kidney Transplantation / *adverse effects KW - Liver Transplantation / *adverse effects KW - Male KW - Middle Aged KW - Molecular Sequence Data KW - Paraparesis, Tropical Spastic / *etiology KW - Viral Load AB - BACKGROUND: Human T-cell lymphotropic virus type I (HTLV-I) causes a subacute myelopathy in less than 5% of chronic carriers. However, the risk of neurologic disease appears to increase in persons infected through blood transfusion. METHODS: We report three recipients of solid organ transplants who developed a subacute myelopathy within 2 years after becoming infected with HTLV-I from a single asymptomatic HTLV-I donor. Genetic studies were performed in and sequences in proviral DNA, and HTLV-I proviral load was measured by real-time quantitative polymerase chain reaction. RESULTS: HTLV-I sequences were obtained in two of these individuals, and they were almost identical and clustered within the Cosmopolitan A HTLV-I subtype, which indicates a common source. All typical changes in Tax amino acid sequence of the HTLV-I Cosmopolitan A were identified, plus two additional changes were noted. Although A has been associated with a greater risk of neurologic disease, both patients were positive for human leukocyte antigen-A*02, which is considered a protective factor. CONCLUSION: Rapid development of subacute myelopathy may occur in recipients of organ transplants from asymptomatic HTLV-I donors. A particular virulence of the virus strain, the large size of the virus inoculum, and the immunosuppressed condition after transplantation may have contributed to produce this unusual rapid development of HTLV-I associated myelopathy. VL - 75 CP - 1 N1 - Toro, Carlos Rodes, Berta Poveda, Eva Soriano, Vincent Case Reports Comment Research Support, Non-U.S. Gov't United States Transplantation Transplantation. 2003 Jan 15;75(1):102-4. ID - 1551 ER -