Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection

Abstract

We report the first case of an occurrence of multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection with no rash and long-term increased titers of serum anti-rubella IgM in a 17-year-old male who had no history of rubella vaccination. He suffered from at least six clinical exacerbations with disseminated hyperintense lesions on FLAIR MR images during the course of 18 months. Repeated methylprednisolone pulse therapy and intravenous immunoglobulin therapy resolved the exacerbations. In patients with multiphasic ADEM of unknown etiology, clinicians should also consider the possibility of preceding infection with rubella virus.

Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection – response to the letter from Wu et al

“…We appreciated the letter from Wu et al 1 commenting on our recently published case report of multiphasic acute disseminated encephalomyelitis (ADEM) after atypical infection with rubella virus. 2 They argued that relapsing–remitting multiple sclerosis (RRMS) should be taken into consideration in our case.…”

Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection

“…We read the case report by Shinoda and colleagues 1 with great interest. They diagnosed multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection in a 17-year-old male based on the clinical manifestations, laboratory investigations, the results of sequential magnetic resonance imaging (MRI) and the pathological findings.…”

“…They diagnosed multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection in a 17-year-old male based on the clinical manifestations, laboratory investigations, the results of sequential magnetic resonance imaging (MRI) and the pathological findings. 1 However, the diagnosis of relapsing–remitting multiple sclerosis (RRMS) could not be ruled out based on the current clinical data.…”

The Relationship between Anti-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease and the Rubella Virus

“…A previous case report described a 17-year-old man with a relapsing course of acute disseminated encephalomyelitis (ADEM) following a rubella infection without a rash, although MOG-Ab was not tested in that case. 10 MOG-Ab-associated disease typically presents with optic neuritis and shows a monophasic course. Nevertheless, its phenotype has recently been reported to be much broader, including an ADEM-like presentation and a relapsing disease course.…”