Khorasan disease: Prevalence of HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) in West Azarbaijan from 2004 to 2007

Because of the low prevalence of Human T Lymphotropic Virus type I (HTLV-I) in comparison with
Khorasan Province, considering HTLV-I as an etiology of spastic paraparesia, it may be neglected in evaluation
of spastic paraparesis in the other regions of Iran. Some reports of spastic paraparetic patients due to HTLV-I
infection in West Azarbaijan, caused us to reconsider the importance of HTLV-I epidemiology in the other areas
of the country.
Methods: All spastic paraparetic patients who referred to Motahari and Imam Khomeini educational hospitals of
Urmia from September 2004 to September 2007 were assessed for HTLV-I infection antibodies.
Results: In our 3 years study, 11 cases were diagnosed as Human T Lymphotropic Virus type I Associated
Myelopathy/Tropical Spastic Paraparesis (HAM/TSP, 2 males and 9 females).The mean age of patients at the
time of diagnosis was 45.8 years. Dorsal and cervical MRI of all patients was normal. Serum Enzyme-Linked
Immuno-Sorbent Assay (ELISA) and Western blot (WB) for anti HTLV-I antibody in all patients was positive. Four
patients underwent for lumbar puncture in which were normal in respect of cells and biochemistry, but positive for
anti-HLTLV-I antibodies.
Conclusion: HAM/TSP detection in West Azarbaijan in spite of its long distance from Khorasan Province shows
the importance of anti-HTLV-I Ab assay in the blood and CSF of every spastic paraparetic patient all over the
country.