To evaluate the human T-cell lymphotropic virus type I (HTLV-I) proviral DNA load among asymptomatic HTLV-I-infected carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), real time PCR using TaqMan probes for the pol gene was performed in two million peripheral blood mononuclear cells (PBMC). The albumin gene was the internal genomic control and MT2 cells were used as positive control. The results are reported as copies/10,000 PBMC, and the detection limit was 10 copies. A total of 89 subjects (44 HAM/TSP and 45 healthy HTLV-I-infected carriers) followed up at the Institute of Infectious Diseases "Emilio Ribas" and in the Neurology Division of Hospital of Clínicas were studied. The asymptomatic HTLV-I-infected carriers had a median number of 271 copies (ranging from 5 to 4756 copies), whereas the HAM/TSP cases presented a median of 679 copies (5-5360 copies) in 10,000 PBMC. Thus, HAM/TSP patients presented a significantly higher HTLV-I proviral DNA load than healthy HTLV-I carriers (P = 0.005, one-way Mann-Whitney test). As observed in other persistent infections, proviral DNA load quantification may be an important tool for monotoring HTLV-I-infected subjects. However, long-term follow-up is necessary to validate this assay in the clinical setting.

Coréia pode ocorrer como manifestação neurológica do lupus eritematoso sistêmico, estando frequentemente associada à presença de anticorpos antifosfolípides. Evidência de coréia como sinal de atividade lúpica não foi descrita. Descrevemos o caso de uma paciente, com lupus eritematoso sistêmico e anticorpos antifosfolípides, que desenvolveu coréia, sendo esta manifestação considerada sinal de atividade dia doença.

Chorea may occur as a neurological manifestation of systemic lupus erythematosus and is often associated with detection of antiphospholipid antibodies. No evidence of chorea as a sign of lupus activity has been established. We describe a patient with systemic lupus erythematosus associated with antiphospholipid antibodies who developed chorea, which has been considered a sign of lupus activity.

É relatado o caso de um paciente de 53 anos de idade com diagnóstico de síndrome de Shy-Drager. Testes laboratoriais e exame físico evidenciaram claramente o distúrbio do sistema nervoso autônomo. Foi também obtido traçado poligráfico do sono durante uma noite completa, que mostrou diminuição do sono tipo MOR e apnéias do tipo central. Os possíveis mecanismos destes achados polissonográficos são discutidos.

The authors report a case of Shy-Drager syndrome in a 53 year-old male patient. Autonomic failure was made evident by physical examiration as well as laboratory tests. A sleep recording showed decreased percentage of REM sleep and apneas of the central type. The possible mechanisms for this sleep disorder are discussed.