Acute disseminated encephalomyelitis following infectious mononucleosis in a toddler

Mohsen, Hassan; Zeinah, Ghaith Farid Abu; Elsotouhy, Ahmed; Mohamed, Khalid

doi:10.1136/bcr-2013-010048

Cited by 14 publications

(6 citation statements)

References 22 publications

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“…Acute demyelinating encephalomyelitis (ADME) is a neurological complication which typically occurs in children or young adults following a viral or bacterial infection . A number of pathogens have been associated with ADME, including Epstein‐Barr virus, herpes simplex virus, influenza virus and Mycoplasma pneumonia . A diagnosis of ADME has also been reported in approximately 1 of 1000 measles cases following the systemic phase of the disease .…”

Section: Acute and Persistent: Extreme Neurotropismmentioning

confidence: 99%

Pathological consequences of systemic measles virus infection

Ludlow

McQuaid²,

Milner

et al. 2014

The Journal of Pathology

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The identification of poliovirus receptor-like 4 (PVRL4) as the second natural receptor for measles virus (MV) has closed a major gap in our understanding of measles pathogenesis, and explains how this predominantly lymphotropic virus breaks through epithelial barriers to transmit to a susceptible host. Advances in the development of wild-type, recombinant MVs which express fluorescent proteins making infected cells readily detectable in living tissues and animals, has also increased our understanding of this important and highly transmissible human disease. Thus, it is timely to review how these advances have provided new insights into MV infection of immune, epithelial and neural cells. This demands access to primate samples that help us understand the early and acute stages of the disease, which are challenging to dissect due to the mild/self-limiting nature of the infection. It also requires well-characterized and rather rare human tissue samples from patients who succumb to neurological sequelae to help study the consequences of the long-term persistence of this RNA virus in vivo. Collectively, these studies have provided unique insights into how the use of two cellular receptors, CD150 and PVRL4, governs the in vivo tissue-specific temporal patterns of virus spread and resulting pathological lesions. Analysis of tissue samples has also demonstrated the importance of differing mechanisms of virus cell-to-cell spread within lymphoid, epithelial and neural tissues in the dissemination of MV during acute and long-term persistent infections. Given the incentive to eradicate MV globally, and the inevitable question as to whether or not vaccination should cease in light of the existence of closely related morbilliviruses, a thorough understanding of measles pathological lesions is essential.

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Section: Acute and Persistent: Extreme Neurotropismmentioning

confidence: 99%

Pathological consequences of systemic measles virus infection

Ludlow

McQuaid²,

Milner

et al. 2014

The Journal of Pathology

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“…Both had EBV titers detected in the CSF by PCR. The remaining cases of ADEM linked with EBV are largely comprised of individual case reports and small studies [63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81].…”

Section: Viruses Common In Adem and Msmentioning

confidence: 99%

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

et al. 2014

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Acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) are demyelinating disorders affecting the central nervous system. An autoimmune aetiology has been proposed for both. ADEM principally affects adolescents following acute infection by a variety of pathogens and has also been reported to occur following vaccination. ADEM typically resolves following medical treatment, whereas MS follows a more relapsing and remitting course. The pathogenesis of MS remains unclear, but it is thought that a combination of infectious and non-infectious environmental factors and host genetics act synergistically to cause disease. A variety of viruses, including Epstein Barr virus, cytomegalovirus, herpes simplex virus and varicella zoster virus, have been implicated as possible infectious triggers. The similar clinical and pathological presentation of ADEM and MS presents a diagnostic challenge for distinguishing ADEM from a first episode of MS. Some cases of ADEM progress to MS for reasons that are not currently clear. This review examines the evidence for infectious agents as triggers for ADEM progressing to MS and suggests potential methods that may facilitate identification of infectious agents that may be responsible for the pathogenesis of ADEM to MS.

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“…The presence of CMV and HSV-IgG antibodies in the serum suggested the potential contribution of these viruses to ADEM. Despite the rarity of the association, increased antibody levels to these viruses in the CSF, as well as diffuse lesions similar to ADEM (Mohsen, Abu Zeinah, Elsotouhy, & Mohamed, 2013;Zaguri, Shelef, Ifergan, & Almog, 2009) in MRI of brain and cervical spinal cord were reported.…”

Section: Discussionmentioning

confidence: 99%

Acute disseminated encephalomyelitis following varicella‐zoster virus infection: Case report of effective treated both in clinical symptom and neuroimaging

2019

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Introduction Acute disseminated encephalomyelitis (ADEM) is an idiopathic inflammatory demyelinating disorder of the central nervous system (CNS). Early treatment is the key for neurological recovery. Methods A case of ADEM associated with varicella‐zoster virus infection was presented, in which magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examinations were included. Results Magnetic resonance imaging of the brain revealed multiple hyperintense lesions at the subcortical level on fluid‐attenuated inversion recovery (FLAIR), and MRI of the spinal cord revealed longitudinally segmented hyperintense lesions at the spinal cord on T2‐weighted images. The patient was treated with methylprednisolone and gancyclovir, and had a favorable recovery. Subsequent MRI of the brain and cervical cord showed the previous abnormal hyperintensities had markedly disappeared. Conclusion A rare case of ADEM with longitudinal segmented hyperintense lesions at the spinal cord on T2‐weighted images was presented. Excellent response to ADEM treatment with high‐dose steroids was reported resulting in a remarkable neurological recovery. A long‐term follow‐up is needed for prognosis.

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Acute disseminated encephalomyelitis following infectious mononucleosis in a toddler

Cited by 14 publications

References 22 publications

Pathological consequences of systemic measles virus infection

Pathological consequences of systemic measles virus infection

Acute disseminated encephalomyelitis progressing to multiple sclerosis: Are infectious triggers involved?

Acute disseminated encephalomyelitis following varicella‐zoster virus infection: Case report of effective treated both in clinical symptom and neuroimaging

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