A serological analysis of viral and bacterial infections associated with neuromyelitis optica

Koga, Michiaki; Takahashi, Toshiyuki; Kawai, Motoharu; Fujihara, Kazuo; Kanda, Takashi

doi:10.1016/j.jns.2010.10.013

Cited by 67 publications

(52 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, various infectious agents have been reported to be associated with neuromyelitis optica (NMO). Single case reports have suggested that viral infections such as those caused by cytomegalovirus (CMV), human simplex virus (HSV), varicella zoster virus (VZV), HIV and human T lymphotropic virus type 1, and bacterial infections such as those caused by Mycoplasma pneumoniae , Mycobacterium tuberculosis and Treponema pallidum are related to the development of NMO 4 5. It has recently been reported that Helicobacter pylori and Chlamydia pneumoniae infections are risk factors for antiaquaporin-4 (AQP4) antibody-positive NMO6 and that amplified AQP4-specific T cells recognise the Clostridium ABC transporter exhibiting Th17 bias in NMO 7.…”

Section: Introductionmentioning

confidence: 99%

Epstein-Barr virus persistence and reactivation in neuromyelitis optica

Masuda

Mori

Arai

et al. 2014

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Epstein-Barr virus persistence and reactivation in neuromyelitis optica

Masuda

Mori

Arai

et al. 2014

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

show abstract

“…Similar to other autoimmune diseases, NMOSD’s immune dysregulation likely results from the interaction of a predisposed host (genetic background) with environmental triggers. Mycoplasma pneumoniae, Mycobacterium tuberculosis, Treponema pallidum, Helicobacter pylori and Chlamydia pneumoniae have been linked to the initiation of NMOSD [15–17]. The gut microbiome may also play a role, as Clostridium perfringens was encountered in high numbers among NMOSD patients when compared to healthy and multiple sclerosis cohorts [18,19].…”

Section: Discussionmentioning

confidence: 99%

Epstein - Barr virus Infection in a Patient with Neuromyelitis Optica Spectrum Disorder and Sjögren’s Syndrome: A Case Report and Review of Literature

et al. 2018

View full text Add to dashboard Cite

Background The association of Neuromyelitis Optica Spectrum Disorders (NMOSD) with autoimmune disorders including Sjögren’s syndrome (SS), is well recognized. Epstein Barr virus (EBV) has been associated to various neurological entities. We describe a case where EBV infection likely preceded NMOSD in a patient with unrecognized SS. The clinical features, work up and management are described. Case presentation A 40-year woman with history of stroke and Guillain-Barre Syndrome (GBS) two years prior, presented with progressive lower extremity weakness and pain. Brain MRI revealed hyperintensities in the cerebellar and parietal lobes consistent with old infarcts, high intensity signal in the white matter and enhancing intramedullary lesion at the level of T2 and the conus medullaris. Cerebrospinal fluid (CSF) revealed no oligoclonal bands. Next day, the patient developed right ankle weakness and urinary incontinence. NMOSD was suspected and pulse steroids initiated. Patient’s weakness resolved. Antinuclear antibodies (ANA), anti-SSA/SSB and Aquaporin 4 antibodies (AQP4Ab) were positive. CSF was positive for EBV. Parotid gland ultrasound revealed non-homogeneous tissue. Ganciclovir and plasmapheresis were started. The patient’s sensation and motor deficits improved and one month after, she had regained motor power and sphincter control. The patient was discharged on oral prednisone and plans for rituximab infusions. On follow-up imaging, Spinal MRI showed areas of myelomalacia and complete resolution at the level of T2 and conus medularis lesions respectively. The patient had no additional flares, but did complain of chronic neuropathic pain. Conclusion NMOSD commonly coexist with other autoimmune diseases. The association of SS and NMOSD is well recognized. EBV infections can present with neurological manifestations however, EBV has also been linked to the development of autoimmunity. In our case, EBV was detected in CSF and antiviral therapy was initiated in addition to the treatment modalities for NMOSD which led to a full recovery in our patient.

show abstract

“…We first suspected the patient to have Miller Fisher syndrome based on her abduction defect after infection, although some cases of NMO following infection have been reported [14, 15]. …”

Section: Discussionmentioning

confidence: 99%

A Case of Neuromyelitis Optica Masquerading as Miller Fisher Syndrome

Furutani¹,

Hata²,

Miyamoto³

et al. 2014

Case Rep Neurol

View full text Add to dashboard Cite

A 22-year-old woman presented with double vision that she had experienced since an infection 2 weeks previously. A neurological examination showed limited bilateral eye abduction, mimicking Miller Fisher syndrome. However, T2-weighted magnetic resonance imaging of her brain revealed hyperintense areas in the tegmentum of the pons, including the abducens nucleus, and her serum anti-aquaporin-4 antibody test was positive. She was finally diagnosed with neuromyelitis optica. Intravenous high-dose steroid therapy immediately improved the patient's abduction palsy, but bilateral optic neuritis manifested during the treatment. Subsequent treatment with plasma exchange improved her optic neuritis symptoms.

show abstract

A serological analysis of viral and bacterial infections associated with neuromyelitis optica

Cited by 67 publications

References 26 publications

Epstein-Barr virus persistence and reactivation in neuromyelitis optica

Epstein-Barr virus persistence and reactivation in neuromyelitis optica

Epstein - Barr virus Infection in a Patient with Neuromyelitis Optica Spectrum Disorder and Sjögren’s Syndrome: A Case Report and Review of Literature

A Case of Neuromyelitis Optica Masquerading as Miller Fisher Syndrome

Contact Info

Product

Resources

About