Tropical Spastic Paraparesis/HTLV-1-Associated Myelopathy (TSP/HAM): Treatment with an Anabolic Steroid Danazol

W J Harrington, Harrington WJ Jr, William J. Harrington, Sheremata WA, William Sheremata, W A Sheremata, Snodgrass SR, S R Snodgrass, SUSAN R. SNODGRASS, SUSAN EMERSON, Emerson S, S Emerson, SCOTT PHILLIPS, S. Phillips, Phillips S, J R Berger, Joseph R. Berger, Berger JR
AIDS research and human retroviruses · 1991 · vol. 7(12) , pp. 1031–1034 · doi:10.1089/aid.1991.7.1031 · PMID:1812944 · W2006236967
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This study investigated danazol treatment in patients with TSP/HAM, finding that five of seven patients showed favorable responses including improved ambulation and decreased spasticity, with mild toxicities.

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Abstract

Tropical spastic paraparesis or HTLV-I-associated myelopathy is a progressive spastic disorder associated with the human T-lymphotropic virus type I. Some cases have responded to prednisone. Danazol is an attenuated androgen with minimal virilizing effects. It is used in the treatment of endometriosis and various autoimmune hematologic diseases shown to be responsive to prednisone. Because danazol is anabolic, useful in prednisone-responsive diseases, and less toxic than prednisone, we gave danazol to 6 patients with TSP and 1 with HIV, HTLV-I-associated myelopathy. Five patients had a favorable response. Two became ambulatory after having been confined to a wheelchair. Three were able to ambulate greater distances (in walkers) than prior to danazol. Three had noticeable decreases in spasticity. Urinary incontinence resolved in two. Physical therapy was variably employed in all except one patient. Two patients who had not responded to physical therapy responded to physical therapy and danazol. One patient did not tolerate danazol and one patient did not improve. Toxicities noted were mild elevations in liver enzymes in 4 patients; these responded to a decrease in dose of danazol; amenorrhea in one and mild fluid retention in one. We conclude that danazol is a useful agent in the management of TSP.

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Condition tags

endometriosis

MeSH descriptors

Danazol Paraparesis, Tropical Spastic Adult Aged Danazol Danazol Danazol Drug Administration Schedule Female Humans Male Middle Aged Paraparesis, Tropical Spastic

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