Isolated Neurogenic Bladder Associated With Human T-Lymphotropic Virus Type 1 Infection in a Renal Transplant Patient From Central Australia: A Case Report

dc.contributor.authorNayar, Sajithen_US
dc.contributor.authorPawar, Basanten_US
dc.contributor.authorEinsiedel, Lloyd Johnen_US
dc.contributor.authorFernandes, Daviden_US
dc.contributor.authorGeorge, Pratishen_US
dc.contributor.authorThomas, Sajanen_US
dc.contributor.authorSajiv, Cherianen_US
dc.date.accessioned2019-01-17T01:06:26Z
dc.date.available2019-01-17T01:06:26Z
dc.date.issued2018-09-07
dc.description© 2018 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (Sept 2018) in accordance with the publisher’s archiving policyen_US
dc.description.abstractHuman T-lymphotropic virus type 1 (HTLV-1) is endemic amongst the Aborigines of the Northern Territory of Australia. HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been associated with this infection. In general population, isolated neurogenic bladder dysfunction in HTLV-1-infected individuals without HAM/TSP has been reported, and the HTLV-1 proviral load has been found to be higher in such patients compared with asymptomatic carriers. In solid organ transplantation, few cases of HAM/TSP have been reported worldwide, but not an isolated neurogenic bladder. Case A 50-year-old indigenous women from Alice Springs with end stage renal disease secondary to diabetic nephropathy with no prior history of bladder dysfunction received a cadaveric renal allograft following which she developed recurrent urinary tract infections. The recipient was seropositive for HTLV-1 infection. HTLV-1 status of donor was not checked. Urodynamic studies revealed stress incontinence and detrusor overactivity without urethral intrinsic sphincter deficiency. She had no features of myelopathy. There was elevation of the serum and cerebrospinal fluid HTLV-1 proviral load. The magnetic resonance imaging myelogram was normal. Pyelonephritis was diagnosed based on clinical features, positive cultures, and renal allograft biopsy. Continuous suprapubic catheter drainage helped preventing further episodes of allograft pyelonephritis in spite of chronic colonization of the urinary tract. Conclusion Isolated bladder dysfunction is a rare manifestation of HTLV-1 infection and is probably associated with high proviral loads. This may adversely affect renal allograft and patient outcomes.en_US
dc.identifier.citationNayar, S., Pawar, B., Einsiedel, L., Fernandes, D., George, P., Thomas, S., & Sajiv, C. (2018). Isolated Neurogenic Bladder Associated With Human T-Lymphotropic Virus Type 1 Infection in a Renal Transplant Patient From Central Australia: A Case Report. Transplantation Proceedings, 50(10), 3940–3942. https://doi.org/10.1016/ j.transproceed.2018.08.031en_US
dc.identifier.doihttps://doi.org/10.1016/j.transproceed.2018.08.031en_US
dc.identifier.issn0041-1345
dc.identifier.urihttp://hdl.handle.net/2328/38837
dc.language.isoenen_US
dc.oaire.license.condition.licenseCC-BY-NC-ND
dc.publisherElsevieren_US
dc.rights© 2018 Elsevier Inc.en_US
dc.rights.holderElsevier Inc.en_US
dc.subjectHuman T-lymphotropic virus type 1 (HTLV-1)en_US
dc.subjectAboriginal Australiansen_US
dc.subjectneurogenic bladderen_US
dc.subjectrenal diseaseen_US
dc.subjectbladder dysfunctionen_US
dc.titleIsolated Neurogenic Bladder Associated With Human T-Lymphotropic Virus Type 1 Infection in a Renal Transplant Patient From Central Australia: A Case Reporten_US
dc.typeArticleen_US
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