Transverse Myelitis as an Unusual Complication of Dengue Fever

Mota, Mânlio Tasso de Oliveira; Estofolete, Cássia Fernanda; Zini, Nathalia; Terzian, Ana Carolina Bernardes; Góngora, Delzi Vinha Nunes de; Maia, Irineu Luiz; Nogueira, Maurício Lacerda

doi:10.4269/ajtmh.16-0284

Cited by 32 publications

(29 citation statements)

References 17 publications

(18 reference statements)

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“…In addition, inflammatory reactions in the CSF are found in most patients. TM/LETM in dengue is rarely encountered, and no more than 12 case reports are available (Renganathan et al, 1996 ; Leao et al, 2002 ; Kunishige et al, 2004 ; Seet et al, 2006 ; Chanthamat and Sathirapanya, 2010 ; Verma et al, 2011a ; Larik et al, 2012 ; Singh et al, 2013 ; Weeratunga et al, 2014a ; Fong et al, 2016 ; Mo et al, 2016 ; Mota et al, 2017 ).…”

Section: Central Neurological System Complicationsmentioning

confidence: 99%

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Neurological Manifestations of Dengue Infection

Zhang

Liu

et al. 2017

Front. Cell. Infect. Microbiol.

153

146

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Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS), peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

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Section: Central Neurological System Complicationsmentioning

confidence: 99%

“…However, the spectrum of TM could be broad, and more attention should be paid to atypical cases. For example, Mota reported a patient confirmed with acute TM without paraparesis following a dengue virus infection last year (Mota et al, 2017 ).…”

Section: Central Neurological System Complicationsmentioning

confidence: 99%

Neurological Manifestations of Dengue Infection

Zhang

Liu

et al. 2017

Front. Cell. Infect. Microbiol.

153

146

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“…120,206 Finally, even though parasite and viral infections such as Enterobium vermicularis, DENV, ZIKV, have been related to TM, the mechanisms to explain these associations have not been elucidated. 6,207,208 CONCLUSIONS AND PERSPECTIVES Infectious diseases play an important role in the development of both GBS and TM. GBS is a post-infectious autoimmune syndrome that could act as sentinel surveillance for several infectious outbreaks, such as arboviruses.…”

Section: Transverse Myelitismentioning

confidence: 99%

Guillain–Barré syndrome, transverse myelitis and infectious diseases

et al. 2018

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Guillain-Barré syndrome (GBS) and transverse myelitis (TM) both represent immunologically mediated polyneuropathies of major clinical importance. Both are thought to have a genetic predisposition, but as of yet no specific genetic risk loci have been clearly defined. Both are considered autoimmune, but again the etiologies remain enigmatic. Both may be induced via molecular mimicry, particularly from infectious agents and vaccines, but clearly host factor and co-founding host responses will modulate disease susceptibility and natural history. GBS is an acute inflammatory immune-mediated polyradiculoneuropathy characterized by tingling, progressive weakness, autonomic dysfunction, and pain. Immune injury specifically takes place at the myelin sheath and related Schwann-cell components in acute inflammatory demyelinating polyneuropathy, whereas in acute motor axonal neuropathy membranes on the nerve axon (the axolemma) are the primary target for immune-related injury. Outbreaks of GBS have been reported, most frequently related to Campylobacter jejuni infection, however, other agents such as Zika Virus have been strongly associated. Patients with GBS related to infections frequently produce antibodies against human peripheral nerve gangliosides. In contrast, TM is an inflammatory disorder characterized by acute or subacute motor, sensory, and autonomic spinal cord dysfunction. There is interruption of ascending and descending neuroanatomical pathways on the transverse plane of the spinal cord similar to GBS. It has been suggested to be triggered by infectious agents and molecular mimicry. In this review, we will focus on the putative role of infectious agents as triggering factors of GBS and TM.

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“…A further 136 were excluded on the basis of title and abstract and 19 studies did not meet the eligibility criteria on full text screening ( Figure 1). The remaining 25 studies were eligible and full text was assessed for inclusion in the final review [7,9,10,[12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Most of the studies were from Asia (76%; 19/25) and the rest from South America (24%; 6/25).…”

Section: Resultsmentioning

confidence: 99%

Risk of Transverse Myelitis Following Dengue Infection: A Systematic Review of the Literature

Badat¹,

Oligbu²

2018

Preprint

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Introduction: Dengue virus (DENV) is one of the most common arbovirus diseases, with a wide spectrum of presentation. Spinal cord involvement in dengue infection (DF) is rare. However, the risk of transverse myelitis (TM) following Dengue has not been systematically assessed. Methods: We undertook a systematic review of published English literature from January 1974 to December 2017 to assess risk of TM and outcomes following DF. Data sources included EMBASE, MEDLINE, Cochrane library, ISI web of knowledge, conference proceedings and references within identified articles. Results: We identified 242 potential studies, 62 were duplicates. A further 136 were excluded on the basis of title and abstract and 19 studies did not meet the eligibility criteria on full text screening. We included 25 publications involving 2672 cases of DF. A small proportion (10.8%, (289/2672)) had neurological complications, of which 2.3% (61/2672) was TM. For articles reporting epidemiological data, the neurological complication was twice in males compared to female 67.7% (130/192) vs. 32.7% (62/192) and 1.5-fold increase TM for males 59.3% (32/54) vs 40.7% (22/54). The mean age at presentation was 33.1years (range 0.75-61), with onset at 11.7days. The method of diagnosing TM due to DF was mainly IgM seropositivity 92% (n = 23/25) and the commonest treatment modality was steroid 78.3% (n = 18/23). Only half had full recovery 50.8% (n = 31/61). There was no mortality following dengue, however, the crude case fatality rate following TM was 3.3% (n = 2/61). Conclusion: This review highlights the risk of TM following dengue. Although neurological complications are rare, especially TM, once set in, it is associated with a significant morbidity.

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Transverse Myelitis as an Unusual Complication of Dengue Fever

Cited by 32 publications

References 17 publications

Neurological Manifestations of Dengue Infection

Neurological Manifestations of Dengue Infection

Guillain–Barré syndrome, transverse myelitis and infectious diseases

Risk of Transverse Myelitis Following Dengue Infection: A Systematic Review of the Literature

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