Naturally Acquired West Nile Virus Encephalomyelitis in Transplant Recipients

Kleinschmidt-DeMasters, B. K.

doi:10.1001/archneur.61.8.1210

Cited by 168 publications

(128 citation statements)

References 24 publications

(53 reference statements)

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“…2,[12][13][14] There is a dearth in the literature, though, regarding its pathophysiologic basis, probably because most patients have survived the disease. Sejvar et al 2 found that 11 of 16 patients (69%) from Louisiana with anti-WNV antibodies had parkinsonism of variable severity.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11] Movement disorders including parkinsonism, tremor and myoclonus have also been described. 2,[12][13][14] We present the clinical and neuropathologic findings in a ABSTRACT: Background: Patients infected with West Nile virus (WNV) may develop acute neurologic disease, which can be severe or even fatal, including WNV meningitis, encephalitis, and an irreversible acute flaccid paralysis or poliomyelitis-like syndrome. Movement disorders have also been described.…”

mentioning

confidence: 99%

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West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

Schafernak

Bigio

2006

Can. j. neurol. sci.

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West Nile virus (WNV) is a mosquito-borne RNA virus in the genus Flavivirus (family Flaviviridae), and a member of the Japanese encephalitis serological group which comprises eight virus species including Japanese encephalitis virus (JEV) and St. Louis encephalitis virus (SLEV), and two subtype viruses. 1 Although most cases of WNV infection are subclinical or result in a mild, self-limited febrile illness known as West Nile fever, a minority of patients (<1%) develop acute neurologic disease, which can be severe and even fatal. 1-3 West Nile virus meningitis and encephalitis are often associated with favorable outcomes, 2 but when infection results in spinal anterior horn cell destruction it can cause an irreversible acute flaccid paralysis or poliomyelitis-like syndrome. [4][5][6][7][8][9][10][11] Movement disorders including parkinsonism, tremor and myoclonus have also been described. 2,[12][13][14] We present the clinical and neuropathologic findings in a ABSTRACT: Background: Patients infected with West Nile virus (WNV) may develop acute neurologic disease, which can be severe or even fatal, including WNV meningitis, encephalitis, and an irreversible acute flaccid paralysis or poliomyelitis-like syndrome. Movement disorders have also been described. Report: We report combined neuronal loss, gliosis, and neurofibrillary tangle formation in the substantia nigra of a 41-year-old man with a history of WNV encephalomyelitis and poliomyelitis-like paralysis. Conclusions: Clinically our patient did not display parkinsonism, however, it is interesting to speculate whether, in the absence of the residual subacute poliomyelitis-like syndrome, the neuropathologic findings could have eventually evolved clinically into WNV-associated postencephalitic parkinsonism. RÉSUMÉ: Encéphalomyélite due au virus du

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

Schafernak

Bigio

2006

Can. j. neurol. sci.

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“…In the CNS, WNV targets cortical, midbrain, cerebellar, and spinal cord neurons leading to their injury or death (31)(32)(33)(34). The high incidence of WNV neuroinvasive disease in patients on anti-T cell therapies (35,36) and in mice with T cell deficiencies (37)(38)(39)(40) indicate that, similar to other neurotropic viruses, the clearance of WNV within the CNS relies heavily on cell-mediated immune responses that promote the migration and effector functions of T cells into the CNS parenchyma. In several of these studies, severe cerebellar involvement was associated with worst outcomes, including fatality (10,41,42).…”

Section: T He Infiltration Of Virus-specific Cd8 T Cells Is Essentialmentioning

confidence: 99%

CXCR3 Mediates Region-Specific Antiviral T Cell Trafficking within the Central Nervous System during West Nile Virus Encephalitis

Zhang

Chan

Liu

et al. 2008

The Journal of Immunology

162

147

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Regional differences in inflammation during viral infections of the CNS suggest viruses differentially induce patterns of chemoattractant expression, depending on their cellular targets. Previous studies have shown that expression of the chemokine CXCL10 by West Nile virus (WNV)-infected neurons is essential for the recruitment of CD8 T cells for the purpose of viral clearance within the CNS. In the current study we used mice deficient for the CXCL10 receptor, CXCR3, to evaluate its role in leukocyte-mediated viral clearance of WNV infection within various CNS compartments. WNV-infected CXCR3-deficient mice exhibited significantly enhanced mortality compared with wild-type controls. Immunologic and virologic analyses revealed that CXCR3 was dispensable for control of viral infection in the periphery and in most CNS compartments but, surprisingly, was required for CD8 T cell-mediated antiviral responses specifically within the cerebellum. WNV-specific, CXCR3-expressing T cells preferentially migrated into the cerebellum, and WNV-infected cerebellar granule cell neurons expressed higher levels of CXCL10 compared with similarly infected cortical neurons. These results indicate that WNV differentially induces CXCL10 within neuronal populations and suggest a novel model for nonredundancy in chemokine-mediated inflammation among CNS compartments.

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“…Other articles have reported cases of WNV infection occurring in SOT recipients (12,15,44,101,158,210,215,265,305,337,383). Most of these cases were community-acquired (de novo) infections or had been acquired through infected blood products.…”

Section: Infections Caused By West Nile Virusmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Naturally Acquired West Nile Virus Encephalomyelitis in Transplant Recipients

Cited by 168 publications

References 24 publications

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

West Nile Virus Encephalomyelitis with Polio-like Paralysis & Nigral Degeneration

CXCR3 Mediates Region-Specific Antiviral T Cell Trafficking within the Central Nervous System during West Nile Virus Encephalitis

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

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