A 42-year-old woman underwent liver transplantation.
His personal history prior to transplantation included hysterectomy in 1978, liver cirrhosis of probable alcoholic origin diagnosed in 1989, UGIB secondary to esophageal varices grade II in 1996 and portal hypertension and ascites.
In February 1998 he was diagnosed with hepatocellular carcinoma.
The patient underwent liver transplantation in October 1998 and was discharged under tacrolimus treatment.
Eighteen months after transplantation, the patient reported for the first time weakness of the lower limbs and loss of sensitivity, evolving within 2 months to a complete paraplegia affecting the urinary bladder.
Physical examination revealed paraparesis with amyoatrophy due to disuse of the lower limbs, greater subjective hypoesthesia in the lower limbs with level D8-D10, involvement of deep sensitivity to vibration in the lower limbs.
OTNs present, alive and resident.
Bilateral extensor CPR.
In this case, the following diagnostic tests were also performed:
Cerebral MRI: involvement of the medullary cord from C2 to D10, also presenting supratentorial lagoon hyperintense lesions mainly at subcortical level of left frontal lobe and also right frontal, parietal and occipital lobe.
SPE: pathological at the level of posterior tibial LCR: positive sex determination for HTLV-I, normal rest.
Blood determination of positive antibodies (ELISA) and presence of the virus (HTLV-I).
The patient was diagnosed with tropical spastic paraparesis and treated with Interferon-á, initially presenting a slight improvement, especially at the distal level of the lower extremities, despite the fact that in recent days there was a decrease in the rate of transamine consumed.
Despite the good initial response, the symptoms have progressively worsened and at this time is dependent for daily life and permanent bladder catheter door after failure of the attempt to bladder reeducation by intermittent catheterization.
Liver transplantation is currently functioning.
Transplantectomy was not indicated in all three cases due to the spread of the virus to blood and nervous systems and, therefore, due to the available measures, to treat and treat the organs and due to their good function
