Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis

Brönnimann, Didier; Vareil, Marc-Olivier; Sibon, Igor; Lagier, Jean-Christophe; Lépidi, Hubert; Pugès, Mathilde; Haneche, Fatiha; Raoult, Didier; Desclaux, A.; Néau, Didier; Cazanave, Charles

doi:10.1007/s15010-018-1173-x

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…Similarly, for the antimalarial hydroxychloroquine, which was one of the most promising therapies tested in patients with COVID-19 at the beginning of the pandemic, a documented association with neuropsychiatric adverse effect, including acute psychosis, is well established [ 62 , 63 , 64 , 65 ]. Hydroxychloroquine typically crosses the blood–brain barrier to concentrate within the CNS [ 66 , 67 , 68 , 69 ]. Several mechanisms have been proposed as contributing to the neuropsychiatric side effects of chloroquine, including increased dopaminergic activity, NMDA excitotoxicity, GABAergic inhibition, and lysosomal dysfunction [ 70 ].…”

Section: Covid-19 and New-onset Psychosis: Possible Confoundersmentioning

confidence: 99%

COVID-19 and New-Onset Psychosis: A Comprehensive Review

Moccia

Kotzalidis

Bartolucci

et al. 2023

JPM

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Psychosis is a multifactorial condition that typically involves delusions, hallucinations, and disorganized thought, speech or behavior. The observation of an association between infectious epidemics and acute psychosis dates back to the last century. Recently, concerns have been expressed regarding COVID-19 and the risk for the development of new-onset psychosis. This article reviewed the current evidence of a possible link between SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We here discuss potential neurobiological and environmental factors as well as a number of challenges in ascribing a causal pathogenic relationship between SARS-CoV-2 infection and new-onset psychosis.

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Section: Covid-19 and New-onset Psychosis: Possible Confoundersmentioning

confidence: 99%

COVID-19 and New-Onset Psychosis: A Comprehensive Review

Moccia

Kotzalidis

Bartolucci

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

“…Hypothalamic involvement manifests as sleep disturbances like hypersomnia or severe insomnia [ 61 ], hyperphagia, polyuria, polydipsia, and libido disorders [ 62 ]. Other CNS manifestations are cerebellar ataxia [ 63 ], seizure and headache [ 12 , 64 ], pyramidal and extrapyramidal symptoms, supranuclear ophthalmoplegia [ 3 , 5 , 14 ], stroke [ 56 ], encephalitis and meningitis [ 14 , 59 , 65 ], and obstructive hydrocephalus [ 66 ]. Signs of sensory–motor myelopathy have been reported in rare cases of spinal cord involvement [ 3 , 6 , 8 , 9 , 13 ], while peripheral involvement is usually related to secondary malabsorption and nutritional deficits [ 5 ].…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Whipple Disease Presenting as Isolated Transverse Myelitis with Permanent Neurological Damage in a Patient with Systemic Lupus Erythematosus: A Case Report of a Difficult Diagnosis with a Literature Review

Saffioti,

Nebiolo,

Caorsi

et al. 2024

Infectious Disease Reports

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We describe an atypical case of Whipple disease exclusively involving the spinal cord in an adolescent receiving immunosuppressive therapy for systemic lupus erythematosus. The diagnosis was particularly difficult since lupus and Whipple disease can present similar clinical features and the patient’s prolonged contact with sewage was initially not mentioned. A literature review of the clinical, imaging, diagnostic, and therapeutic challenges of Whipple disease is also performed.

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Of mice, microglia, and (wo)men: a case series and mechanistic investigation of hydroxychloroquine for complex regional pain syndrome

Haight

Johnson

Carroll

et al. 2020

PR9

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Introduction: Complex regional pain syndrome (CRPS) is a condition that occurs after minor trauma characterized by sensory, trophic, and motor changes. Although preclinical studies have demonstrated that CRPS may be driven in part by autoinflammation, clinical use of immune-modulating drugs in CRPS is limited. Hydroxychloroquine (HCQ) is a disease-modifying antirheumatic drug used to treat malaria and autoimmune disorders that may provide benefit in CRPS. Objectives: To describe the use of HCQ in patients with refractory CRPS and investigate possible mechanisms of benefit in a mouse model of CRPS. Methods: We initiated HCQ therapy in 7 female patients with refractory CRPS undergoing treatment at the Stanford Pain Management Center. We subsequently undertook studies in the mouse tibial fracture–casting model of CRPS to identify mechanisms underlying symptom reduction. We evaluated behavior using mechanical allodynia and spinal cord autoinflammation by immunohistochemistry and enzyme-linked immunosorbent assay. Results: We treated 7 female patients with chronic, refractory CRPS with HCQ 200 mg twice daily for 2 months, followed by 200 mg daily thereafter. Two patients stopped HCQ secondary to lack of response or side effects. Overall, HCQ significantly improved average numerical rating scale pain from 6.8 ± 1.1 before HCQ to 3.8 ± 1.9 after HCQ treatment. In the tibial fracture–casting mouse model of CRPS, we observed reductions in allodynia, paw edema, and warmth following daily HCQ treatment starting at 3 weeks after injury. Spinal cord dorsal horn microglial activation and cytokine levels were also reduced by HCQ treatment. Conclusion: Together, these preclinical and clinical results suggest that HCQ may benefit patients with CRPS at least in part by modulating autoinflammation and support further investigation into the use of HCQ for CRPS.

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Limbic encephalitis as a relapse of Whipple’s disease with digestive involvement and spondylodiscitis

Abstract: This case is to the best of our knowledge the first proof of the effective brain-blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.

Cited by 6 publications

References 13 publications

COVID-19 and New-Onset Psychosis: A Comprehensive Review

COVID-19 and New-Onset Psychosis: A Comprehensive Review

Whipple Disease Presenting as Isolated Transverse Myelitis with Permanent Neurological Damage in a Patient with Systemic Lupus Erythematosus: A Case Report of a Difficult Diagnosis with a Literature Review

Of mice, microglia, and (wo)men: a case series and mechanistic investigation of hydroxychloroquine for complex regional pain syndrome

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