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Koju Kamoi, Yukiko Terada, Kazunori Miyata, Manabu Mochizuki; Association of HTLV-1 uveitis with systemic inflammatory diseases and adult T cell leukemia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6280.
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Human T cell lymphotropic virus type 1 (HTLV-1) is the first retrovirus described as a causative agent of human disease. HTLV-1 infection affects systemic tolerance and causes ocular inflammation, i.e. HTLV-1 uveitis (HU). The infection also causes adult T cell leukemia (ATL), which leads fatal condition. We investigate the association of HU with systemic inflammatory diseases and ATL through clinical survey.
The clinical records of 575 patients with uveitis between February 2012 and May 2013 at Miyata Eye Hospital (southern part of Japan), a referral eye center of the HTLV-1 highly endemic region, were retrospectively reviewed.
The survey showed the second most clinical entity of uveitis was HU (10.6%), followed by Sarcoidosis. Median duration of disease was 9.5 years (0.5-24 years) in HU patients. Medical history of the HU patients revealed that 8 patients (13.1%) had previous history of Graves’ disease with hyperthyroidism. As for other complications, 6 patients (9.8%) developed HTLV-I- associated myelopathy, and 4 patients (6.6%) developed Rheumatoid arthritis. Other inflammatory complications (Interstitial pneumonitis and Sjögren's syndrome) were also seen in 2 patients. It is noteworthy that none of HU patients developed ATL in the survey.
It is revealed that a close relation between HU and systemic inflammatory complications, however, there was no association of HU with development of ATL. In addition to further clinical survey, basic research is needed to identify the reason why non-malignant /inflammatory T cells in HU hardly transform into malignant /leukemic T cells in ATL, which may clarify fundamental mechanisms of HTLV-1 infection.
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