Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient

Giobbia, Mario; Carniato, Antonella; Scotton, Pier Giorgio; Marchiori, G. C.; Vaglia, A.

doi:10.1007/bf02561538

Cited by 25 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Infections can cause TM through direct tissue damage, [39-41] or by immune-mediated infection-triggered tissue damage which may be due to molecular mimicry or superantigen effect. The molecular mimicry theory is based on the fact that several infectious agents are capable of encoding molecular structures (e.g.…”

Section: Idiopathic Transverse Myelitismentioning

confidence: 99%

Idiopathic Transverse Myelitis and Neuromyelitis Optica: Clinical Profiles,Pathophysiology and Therapeutic Choices

Awad

Stüve

2011

View full text Add to dashboard Cite

Transverse myelitis is a focal inflammatory disorder of the spinal cord which may arise due to different etiologies. Transverse myelitis may be idiopathic or related/secondary to other diseases including infections, connective tissue disorders and other autoimmune diseases. It may be also associated with optic neuritis (neuromyelitis optica), which may precede transverse myelitis. In this manuscript we review the pathophysiology of different types of transverse myelitis and neuromyelitis optica and discuss diagnostic criteria for idiopathic transverse myelitis and risk of development of multiple sclerosis after an episode of transverse myelitis. We also discuss treatment options including corticosteroids, immunosuppressives and monoclonal antibodies, plasma exchange and intravenous immunoglobulins.

show abstract

Section: Idiopathic Transverse Myelitismentioning

confidence: 99%

Idiopathic Transverse Myelitis and Neuromyelitis Optica: Clinical Profiles,Pathophysiology and Therapeutic Choices

Awad

Stüve

2011

View full text Add to dashboard Cite

show abstract

“…2,9 In 1995 and 1999 two additional cases were published. 10 In the patient from Pakistan, 10 spinal MRI was normal and PCR was not performed, while in the patient from Italy, 11 no details or images were provided concerning the`hyperintense signal a ecting the lower level of the thoracic spinal cord' and the PCR for CMV-DNA was positive in the serum and negative in the CSF, 11 as in our case. Nevertheless, our case compared to the above 5 ± 8,10,11 is unique for several reasons:…”

Section: Cmv-associated Myelitis D Karacostas Et Almentioning

confidence: 66%

“…(2) The serological pro®le for CMV antibodies (stepwise increase of IgG that persisted after 4 months and parallel decrease of IgM, reaching negative value after initial increase) along with the CMV-DNA detection both in the serum and PBLs, evidenced a recent primary infection by CMV. 11 Although without tissue biopsy, it may be di cult or impossible to distinguish between direct spinal cord viral invasion and tissue injury, 5,10 CMVinduced vasculitis 5 or post-infectious immunemediated process, 5,12 our patient's impressive clinical recovery and complete MRI resolution, along with the negative CMV-DNA detection in the CSF, rather support the latter pathogenetic mechanism. (3) EBV-DNA was detected in PBLs but not in the serum or the CSF and was accompanied by increased serum titers of NA-IgG, EA-IgG and IgM antibodies that all progressively declined and were found negative (EA-IgG, IgM) or very low (NA-IgG) at 4 months.…”

Section: Cmv-associated Myelitis D Karacostas Et Almentioning

confidence: 83%

See 1 more Smart Citation

Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient

et al. 2002

View full text Add to dashboard Cite

Design: Single case report. Objective: To report a rare case of cytomegalovirus (CMV)-associated transverse myelitis (TM) in the immunocompetent host. Settings: Collaboration between a Neurology and Radiology University Department in Greece and a Molecular Virology Department in Cyprus. Patient: A 16-year-old male student developed an acute febrile illness followed shortly by TM, that resulted in paraplegia over 24 h. Rapid clinical improvement was followed by complete recovery in 2 months. Extensive laboratory work-up excluded other possible causes of TM and showed no evidence of an immunocompromised state. Antiviral serological data, identi®cation of the viral genome by polymerase chain reaction and serial spinal cord magnetic resonance imaging ®ndings, supported the diagnosis of CMV-associated TM in a nonimmunocompromised patient. Conclusions: Our case further indicates that CMV infection should be included in the di erential diagnosis of TM of uncertain etiology, in the immunocompetent patient. Clinical, immunological and neuroimaging ®ndings indicate that post-infectious immune mediated in¯ammation, seems the most probable pathogenetic mechanism in this case.

show abstract

“…While cytomegalovirus is an identified cause of myelitis in immunocompromised hosts, it is rare in the immunocompetent people with only few published case reports (Table 1). Cytomegalovirus PCR has demonstrated the presence of CMV DNA in blood in only two reported cases of CMV associated transverse myelitis in the immunocompetent patients [7,8]. In other immunocompetent patients with CMV transverse myelitis, either PCR was not done or was negative.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus associated transverse myelitis in an immunocompetent host with DNA detection in cerebrospinal fluid; a case report

et al. 2012

View full text Add to dashboard Cite

BackgroundCytomegalovirus associated transverse myelitis among immunocompetent adults has been rarely reported. We report a patient presenting with clinical myelitis followed by previously unreported finding of cytomegalovirus deoxyribonucleic acid in cerebrospinal fluid.Case reportA forty year old immunocompetent male presented with acute onset progressive bilateral lower limb weakness. His spinal magnetic resonance imaging findings, cerebrospinal fluid analysis and clinical picture were compatible with transverse myelitis. Polymerase chain reaction of the cerebrospinal fluid for cytomegalovirus was positive while other infectious agents were not detected by serology or polymerase chain reaction. He was treated with intravenous ganciclovir with partial clinical response.ConclusionViral genome detection in the cerebrospinal fluid was performed but negative in five out of ten reported cases of cytomegalovirus associated transverse myelitis in the immunocompetent host. In previous cases the inability to isolate the virus in cerebrospinal fluid was considered favouring an immunological mechanism leading to pathogenesis rather than direct viral toxicity but this case is against that theory. This case highlights the fact that Cytomegalovirus should be considered as an aetiological agent in patients with transverse myelitis and that the virus may cause serious infections in immunocompetent host. Therefore this report is of importance to neurologists and physicians in general.

show abstract

Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient

Cited by 25 publications

References 9 publications

Idiopathic Transverse Myelitis and Neuromyelitis Optica: Clinical Profiles,Pathophysiology and Therapeutic Choices

Idiopathic Transverse Myelitis and Neuromyelitis Optica: Clinical Profiles,Pathophysiology and Therapeutic Choices

Cytomegalovirus-associated transverse myelitis in a non-immunocompromised patient

Cytomegalovirus associated transverse myelitis in an immunocompetent host with DNA detection in cerebrospinal fluid; a case report

Contact Info

Product

Resources

About