{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:46:37Z","timestamp":1772844397422,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,9,5]]},"abstract":"<jats:p>Human T-lymphotropic virus 1 (HTLV-1) is frequent in Peru; an estimated 1\u20132% of the Peruvian population carry this retrovirus. HTLV-1-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) is a chronic disabling disease that affects about 1% of the carriers of HTLV-1. It is not yet known why some HTLV-1-infected people develop HAM\/TSP while others do not. In this case report, we present a family with an unusually high burden of HAM\/TSP: 5 (the 2 parents and 3 of their children) of 7 HTLV-1 carriers developed the same disease. We describe the clinical presentation and discuss the clustering of disease against the current knowledge of the pathogenesis of HAM\/TSP. Families such as this may hold the key to discovering which factors trigger the development of HAM\/TSP.<\/jats:p>","DOI":"10.1136\/bcr-2015-209619","type":"journal-article","created":{"date-parts":[[2015,9,21]],"date-time":"2015-09-21T08:07:41Z","timestamp":1442822861000},"page":"bcr2015209619","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["A Peruvian family with a high burden of HTLV-1-associated myelopathy\/tropical spastic paraparesis"],"prefix":"10.1136","volume":"2015","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5240-3002","authenticated-orcid":false,"given":"Carolina","family":"Alvarez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristien","family":"Verdonck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mart\u00edn","family":"Tipismana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Gotuzzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,9,21]]},"reference":[{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.1","doi-asserted-by":"publisher","DOI":"10.1590\/S1020-49892007000900001"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2006.22.931"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.3","doi-asserted-by":"publisher","DOI":"10.1086\/423957"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.4","first-page":"1096","article-title":"The risk of development of HTLV-I-associated myelopathy\/tropical spastic paraparesis among persons infected with HTLV-I","volume":"3","author":"Kaplan","year":"1990","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.5","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199802010-00011"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.6","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.53.1.4"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.7","doi-asserted-by":"publisher","DOI":"10.3109\/13550280009030753"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.8","doi-asserted-by":"publisher","DOI":"10.1086\/315897"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.9","doi-asserted-by":"publisher","DOI":"10.3109\/13550289809114225"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.10","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.7.3848"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)93147-8"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.12","doi-asserted-by":"publisher","DOI":"10.1016\/0923-2516(96)81078-8"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0086144"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.14","first-page":"308","article-title":"Human T-lymphotropic virus type I tax polymorphisms in a transmission cohort: no association between sequence variation and disease manifestations","volume":"2","author":"Sambor","year":"1999","journal-title":"J Hum Virol"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.15","doi-asserted-by":"publisher","DOI":"10.1099\/0022-1317-74-11-2531"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.16","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.165.12.7278"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.17","doi-asserted-by":"publisher","DOI":"10.1086\/342953"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.18","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.8.1045"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.19","doi-asserted-by":"publisher","DOI":"10.1080\/13550280601039634"},{"key":"2025042707092378000_2015.sep21_1.bcr2015209619.20","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2004000100001"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-209619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T14:09:27Z","timestamp":1745762967000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-209619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,21]]},"references-count":20,"alternative-id":["10.1136\/bcr-2015-209619"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-209619","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,21]]}}}