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[PMID]:28461111
[Au] Autor:Kahlmann V; Roodbol J; van Leeuwen N; Ramakers CRB; van Pelt D; Neuteboom RF; Catsman-Berrevoets CE; de Wit MCY; Jacobs BC
[Ad] Endereço:Department of Neurology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands; Department of Paediatric Neurology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands. Electronic address: vivienne.kahlmann@gmail.com.
[Ti] Título:Validated age-specific reference values for CSF total protein levels in children.
[So] Source:Eur J Paediatr Neurol;21(4):654-660, 2017 Jul.
[Is] ISSN:1532-2130
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To define age-specific reference values for cerebrospinal fluid (CSF) total protein levels for children and validate these values in children with Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). METHODS: Reference values for CSF total protein levels were determined in an extensive cohort of diagnostic samples from children (<18 year) evaluated at Erasmus Medical Center/Sophia Children's Hospital. These reference values were confirmed in children diagnosed with disorders unrelated to raised CSF total protein level and validated in children with GBS, ADEM and MS. RESULTS: The test results of 6145 diagnostic CSF samples from 3623 children were used to define reference values. The reference values based on the upper limit of the 95% CI (i.e. upper limit of normal) were for 6 months-2 years 0.25 g/L, 2-6 years 0.25 g/L, 6-12 years 0.28 g/L, 12-18 years 0.34 g/L. These reference values were confirmed in a subgroup of 378 children diagnosed with disorders that are not typically associated with increased CSF total protein. In addition, the CSF total protein levels in these children in the first 6 months after birth were highly variable (median 0.47 g/L, IQR 0.26-0.65). According to these new reference values, CSF total protein level was elevated in 85% of children with GBS, 66% with ADEM and 23% with MS. CONCLUSION: More accurate age-specific reference values for CSF total protein levels in children were determined. These new reference values are more sensitive than currently used values for diagnosing GBS and ADEM in children.
[Mh] Termos MeSH primário: Líquido Cefalorraquidiano/química
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Estudos de Coortes
Encefalomielite Aguda Disseminada/líquido cefalorraquidiano
Feminino
Síndrome de Guillain-Barré/líquido cefalorraquidiano
Seres Humanos
Masculino
Valores de Referência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29245364
[Au] Autor:Kim JK; Han SA; Kim SJ
[Ad] Endereço:Department of Pediatrics, Chonbuk National University School of Medicine, Jeonju, Korea.
[Ti] Título:X-linked Charcot-Marie-Tooth disease with GJB1 mutation presenting as acute disseminated encephalomyelitis-like illness: A case report.
[So] Source:Medicine (Baltimore);96(49):e9176, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Charcot-Marie-Tooth disease (CMT) is typically an autosomal dominant, inherited neuropathy, although there is a rare male X-linked CMT. Such patients show central nervous system (CNS) involvement in addition to peripheral neuropathy. Recently, we encountered a patient who presented with acute disseminated encephalomyelitis (ADEM)-like symptoms, but was later diagnosed as having X-linked CMT (CMTX) due to a mutation. PATIENT CONCERNS: A previously healthy 11-year-old boy was admitted for a sudden transient weakness of his left side extremities. DIAGNOSES: The patient was diagnosed with left side hemiparesis. Brain magnetic resonance imaging (MRI) showed ADEM-like demyelinating lesions on both centrum semiovale. A diagnosis of probable ADEM was made, and the patient soon recovered. After 4 months, a second MRI showed complete resolution of the brain lesions. However, the symptoms recurred 2 years later. A third MRI revealed white matter abnormalities, and a physical examination demonstrated pes cavus deformities and peripheral muscle wasting of both lower extremities. INTERVENTIONS: On the basis of the brain MRI lesions and physical findings, we suspected CMTX. Genotyping confirmed a mutation in the GJB1 gene. OUTCOMES: When the symptoms recurred 2 years later, dysarthria and demyelinating MRI lesions were present. We could not identify any triggering factors. LESSONS: Differential diagnosis of recurrent ADEM-like lesions in the cerebral white matter and peripheral neuropathy should include the possibility of CMTX disease.
[Mh] Termos MeSH primário: Doença de Charcot-Marie-Tooth/diagnóstico
Doença de Charcot-Marie-Tooth/genética
Conexinas/genética
[Mh] Termos MeSH secundário: Encéfalo/diagnóstico por imagem
Encéfalo/patologia
Doença de Charcot-Marie-Tooth/fisiopatologia
Criança
Diagnóstico Diferencial
Encefalomielite Aguda Disseminada/diagnóstico
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Mutação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Connexins); 0 (connexin 32)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009176


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[PMID]:28471623
[Au] Autor:Tomljenovic L
[Ad] Endereço:Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Título:Guillian-Barré Syndrome and Acute Disseminated Encephalomyelitis related to the Bivalent Oral Poliovirus Vaccine.
[So] Source:Isr Med Assoc J;18(10):619-622, 2016 Oct.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Encefalomielite Aguda Disseminada/etiologia
Síndrome de Guillain-Barré/etiologia
Vacina Antipólio Oral/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Encefalomielite Aguda Disseminada/imunologia
Síndrome de Guillain-Barré/imunologia
Seres Humanos
Vacina Antipólio Oral/efeitos adversos
Vacina Antipólio Oral/imunologia
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Poliovirus Vaccine, Oral)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:28471617
[Au] Autor:Tasher D; Kopel E; Anis E; Grossman Z; Somekh E
[Ad] Endereço:Pediatric Infectious Diseases Unit, Wolfson Medical Center, Holon, Israel.
[Ti] Título:Causality Assessment of Serious Neurologic Adverse Events Following bOPV National Vaccination Campaign in Israel.
[So] Source:Isr Med Assoc J;18(10):590-593, 2016 Oct.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: During 2013-2014 Israel experienced a continuous circulation of wild poliovirus type 1 (WPV1) but with no clinical cases. WPV1 circulation was gradually terminated following a national vaccination campaign of bivalent oral poliovirus vaccine (bOPV) for 943,587 children < 10 years. Four cases of children with neurological manifestations that appeared following bOPV vaccinations were reported during the campaign: three of Guillain-Barré syndrome (GBS) and one of acute disseminated encephalomyelitis (ADEM). OBJECTIVES: To present an analysis of these cases, the rapid response and the transparent publication of the results of this analysis. METHODS: The clinical, laboratory and epidemiological data of these four patients were available during the analysis. In addition, data regarding the incidence of GBS and ADEM during previous years, and reported cases of acute flaccid paralysis (AFP) and the incidence of Campylobacter jejuni enteritis were collected from the Epidemiology Department of the Israel Ministry of Health. RESULTS: The incidence of GBS among bOPV-vaccinated children was not higher than among bOPV-unvaccinated children. For all the cases reviewed the "incubation period" from vaccination to the event was longer than expected and other more plausible causes for the neurologic manifestations were found. There is no evidence in the literature of a causal relationship between bOPV and ADEM. CONCLUSIONS: There was no association between the bOPV vaccine and the reported neurological manifestations. We believe that our experience may assist other public health professionals when confronting a similar problem of alleged side effects during a mass medical intervention.
[Mh] Termos MeSH primário: Encefalomielite Aguda Disseminada/etiologia
Síndrome de Guillain-Barré/etiologia
Vacina Antipólio Oral/administração & dosagem
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Encefalomielite Aguda Disseminada/epidemiologia
Síndrome de Guillain-Barré/epidemiologia
Seres Humanos
Programas de Imunização
Incidência
Lactente
Israel/epidemiologia
Poliomielite/prevenção & controle
Poliovirus/isolamento & purificação
Vacina Antipólio Oral/efeitos adversos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Poliovirus Vaccine, Oral)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:28768844
[Au] Autor:Hennes EM; Baumann M; Schanda K; Anlar B; Bajer-Kornek B; Blaschek A; Brantner-Inthaler S; Diepold K; Eisenkölbl A; Gotwald T; Kuchukhidze G; Gruber-Sedlmayr U; Häusler M; Höftberger R; Karenfort M; Klein A; Koch J; Kraus V; Lechner C; Leiz S; Leypoldt F; Mader S; Marquard K; Poggenburg I; Pohl D; Pritsch M; Raucherzauner M; Schimmel M; Thiels C; Tibussek D; Vieker S; Zeches C; Berger T; Reindl M; Rostásy K; BIOMARKER Study Group
[Ad] Endereço:Author affiliations are provided at the end of the article.
[Ti] Título:Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome.
[So] Source:Neurology;89(9):900-908, 2017 Aug 29.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the prognostic value of MOG antibodies (abs) in the differential diagnosis of acquired demyelinating syndromes (ADS). METHODS: Clinical course, MRI, MOG-abs, AQP4-abs, and CSF cells and oligoclonal bands (OCB) in children with ADS and 24 months of follow-up were reviewed in this observational prospective multicenter hospital-based study. RESULTS: Two hundred ten children with ADS were included and diagnosed with acute disseminated encephalomyelitis (ADEM) (n = 60), neuromyelitis optica spectrum disorder (NMOSD) (n = 12), clinically isolated syndrome (CIS) (n = 101), and multiple sclerosis (MS) (n = 37) after the first episode. MOG-abs were predominantly found in ADEM (57%) and less frequently in NMOSD (25%), CIS (25%), or MS (8%). Increased MOG-ab titers were associated with younger age ( = 0.0001), diagnosis of ADEM ( = 0.005), increased CSF cell counts ( = 0.011), and negative OCB ( = 0.012). At 24-month follow-up, 96 children had no further relapses. Thirty-five children developed recurrent non-MS episodes (63% MOG-, 17% AQP4-abs at onset). Seventy-nine children developed MS (4% MOG-abs at onset). Recurrent non-MS episodes were associated with high MOG-ab titers ( = 0.0003) and older age at onset ( = 0.024). MS was predicted by MS-like MRI ( < 0.0001) and OCB ( = 0.007). An MOG-ab cutoff titer ≥1:1,280 predicted a non-MS course with a sensitivity of 47% and a specificity of 100% and a recurrent non-MS course with a sensitivity of 46% and a specificity of 86%. CONCLUSIONS: Our results show that the presence of MOG-abs strongly depends on the age at disease onset and that high MOG-ab titers were associated with a recurrent non-MS disease course.
[Mh] Termos MeSH primário: Encefalomielite Aguda Disseminada/imunologia
Esclerose Múltipla/imunologia
Glicoproteína Mielina-Oligodendrócito/sangue
Glicoproteína Mielina-Oligodendrócito/imunologia
Neuromielite Óptica/imunologia
[Mh] Termos MeSH secundário: Adolescente
Autoanticorpos
Biomarcadores/metabolismo
Criança
Pré-Escolar
Diagnóstico Diferencial
Progressão da Doença
Encefalomielite Aguda Disseminada/sangue
Encefalomielite Aguda Disseminada/líquido cefalorraquidiano
Encefalomielite Aguda Disseminada/diagnóstico por imagem
Feminino
Seguimentos
Seres Humanos
Lactente
Imagem por Ressonância Magnética
Masculino
Esclerose Múltipla/sangue
Esclerose Múltipla/líquido cefalorraquidiano
Esclerose Múltipla/diagnóstico por imagem
Neuromielite Óptica/sangue
Neuromielite Óptica/líquido cefalorraquidiano
Neuromielite Óptica/diagnóstico por imagem
Bandas Oligoclonais
Prognóstico
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Biomarkers); 0 (MOG protein, human); 0 (Myelin-Oligodendrocyte Glycoprotein); 0 (Oligoclonal Bands)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004312


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[PMID]:28665957
[Au] Autor:Kamel MG; Nam NT; Han NHB; El-Shabouny AE; Makram AM; Abd-Elhay FA; Dang TN; Hieu NLT; Huong VTQ; Tung TH; Hirayama K; Huy NT
[Ad] Endereço:Faculty of Medicine, Minia University, Minia, Egypt.
[Ti] Título:Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis.
[So] Source:PLoS Negl Trop Dis;11(6):e0005715, 2017 Jun.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dengue is one of the most common infectious diseases. The aim of this study was to systematically review acute disseminated encephalomyelitis (ADEM) and to represent a new case. METHODOLOGY/PRINCIPAL FINDINGS: We searched for articles in nine databases for case reports, series or previous reviews reporting ADEM cases in human. We used Fisher's exact and Mann-Whitney U tests. Classification trees were used to find the predictors of the disease outcomes. We combined findings using fixed- and random-effects models. A 13-year-old girl was admitted to the hospital due to fever. She has a urinary retention. The neurological examinations revealed that she became lethargic and quadriplegic. She had upper limbs weakness and lower limbs complete paraplegia. Her status gradually improved after the treatment. She was nearly intact with the proximal part of her legs had a mild weakness in discharge. The prevalence of ADEM among dengue patients was 0.4% [95% confidence intervals (95% CI) 0.1-2.5%], all neurological disorders among dengue was 2.6% [95% CI 1.8-3.8%], and ADEM among neurological disorders was 6.8% [95% CI 3.4-13%]. The most frequent manifestation of ADEM was altered sensorium/consciousness (58%), seizures and urination problems (35%), vision problems (31%), slurred speech (23%), walk problems (15%) then ataxia (12%). There was a significant difference between cases having complete recovery or bad outcomes in the onset day of neurological manifestations being earlier and in temperature being higher in cases having bad outcomes (p-value < 0.05). This was confirmed by classification trees which included these two variables. CONCLUSIONS/SIGNIFICANCE: The prevalence of ADEM among dengue and other dengue-related neurological disorders is not too rare. The high fever of ADEM cases at admission and earlier onset day of neurological manifestations are associated with the bad outcomes.
[Mh] Termos MeSH primário: Dengue/complicações
Encefalomielite Aguda Disseminada/etiologia
Encefalomielite Aguda Disseminada/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Proteínas de Transporte
Criança
Pré-Escolar
Encefalomielite Aguda Disseminada/epidemiologia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Proteínas de Membrana
Meia-Idade
Prevalência
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Carrier Proteins); 0 (Membrane Proteins); 0 (TMEM20 protein, human)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005715


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[PMID]:28433979
[Au] Autor:Samra K; Boon IS; Packer G; Jacob S
[Ad] Endereço:Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
[Ti] Título:Lethal high: acute disseminated encephalomyelitis (ADEM) triggered by toxic effect of synthetic cannabinoid .
[So] Source:BMJ Case Rep;2017, 2017 Apr 22.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A previously well 25-year-old man presented with agitation, double incontinence and left-sided incoordination. His symptoms started after smoking a synthetic cannabinoid ( ) 5 days earlier. Over 48 hours, he developed aphasia, generalised hypertonia, hyper-reflexia and dense left hemiparesis. This progressed to profuse diaphoresis, fever, tachycardia, hypertension and a possible seizure necessitating admission to the intensive care unit. CT head and cerebrospinal fluid analysis were unremarkable. MRI brain demonstrated asymmetric multifocal hyperintense lesions in white and grey matter, which raised suspicions of acute disseminated encephalomyelitis (ADEM). An electroencephalogram showed widespread brain wave slowing, indicating diffuse cerebral dysfunction. Cerebral angiogram was normal. Toxicology analysis of the substance confirmed a potent synthetic cannabinoid , technically legal at the time. The patient made a slow but significant recovery after a course of intravenous methylprednisolone, intravenous immunoglobulins and oral steroids, and was later transferred to a rehabilitation bed.
[Mh] Termos MeSH primário: Canabinoides/toxicidade
Encefalomielite Aguda Disseminada/diagnóstico por imagem
Substância Cinzenta/diagnóstico por imagem
Substância Branca/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Encefalomielite Aguda Disseminada/induzido quimicamente
Encefalomielite Aguda Disseminada/tratamento farmacológico
Seres Humanos
Imunoglobulinas Intravenosas/administração & dosagem
Imunoglobulinas Intravenosas/uso terapêutico
Imagem por Ressonância Magnética
Masculino
Metilprednisolona/administração & dosagem
Metilprednisolona/uso terapêutico
Esteroides/administração & dosagem
Esteroides/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cannabinoids); 0 (Immunoglobulins, Intravenous); 0 (Steroids); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170628
[Lr] Data última revisão:
170628
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170424
[St] Status:MEDLINE


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[PMID]:28420330
[Au] Autor:Nakamura Y; Nakajima H; Tani H; Hosokawa T; Ishida S; Kimura F; Kaneko K; Takahashi T; Nakashima I
[Ad] Endereço:Division of Neurology, Department of Internal Medicine IV, Osaka Medical College, Daigakumachi 2-7, Takatsukishi, Osaka, 569-8686, Japan. in1394@osaka-med.ac.jp.
[Ti] Título:Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report.
[So] Source:BMC Neurol;17(1):76, 2017 Apr 19.
[Is] ISSN:1471-2377
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Anti-Myelin oligodendrocyte glycoprotein (MOG) antibodies are detected in various demyelinating diseases, such as pediatric acute disseminated encephalomyelitis (ADEM), recurrent optic neuritis, and aquaporin-4 antibody-seronegative neuromyelitis optica spectrum disorder. We present a patient who developed anti-MOG antibody-positive ADEM following infectious mononucleosis (IM) due to Epstein-Barr virus (EBV) infection. CASE PRESENTATION: A 36-year-old healthy man developed paresthesia of bilateral lower extremities and urinary retention 8 days after the onset of IM due to primary EBV infection. The MRI revealed the lesions in the cervical spinal cord, the conus medullaris, and the internal capsule. An examination of the cerebrospinal fluid revealed pleocytosis. Cell-based immunoassays revealed positivity for anti-MOG antibody with a titer of 1:1024 and negativity for anti-aquaporin-4 antibody. His symptoms quickly improved after steroid pulse therapy followed by oral betamethasone. Anti-MOG antibody titer at the 6-month follow-up was negative. CONCLUSIONS: This case suggests that primary EBV infection would trigger anti-MOG antibody-positive ADEM. Adult ADEM patients can be positive for anti-MOG antibody, the titers of which correlate well with the neurological symptoms.
[Mh] Termos MeSH primário: Autoanticorpos/imunologia
Encefalomielite Aguda Disseminada/imunologia
Infecções por Vírus Epstein-Barr/imunologia
Mononucleose Infecciosa/imunologia
Glicoproteína Mielina-Oligodendrócito/imunologia
[Mh] Termos MeSH secundário: Adulto
Aquaporina 4/imunologia
Medula Cervical/patologia
Encefalomielite Aguda Disseminada/complicações
Infecções por Vírus Epstein-Barr/complicações
Seres Humanos
Mononucleose Infecciosa/complicações
Cápsula Interna/patologia
Leucocitose/líquido cefalorraquidiano
Imagem por Ressonância Magnética
Masculino
Medula Espinal/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Aquaporin 4); 0 (Autoantibodies); 0 (Myelin-Oligodendrocyte Glycoprotein)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1186/s12883-017-0858-6


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[PMID]:28367948
[Au] Autor:Horie J; Suzuki K; Nakamura T; Okamura M; Iwasaki A; Hirata K
[Ad] Endereço:Department of Neurology, Dokkyo Medical University.
[Ti] Título:Human herpesvirus 6 encephalitis followed by acute disseminated encephalomyelitis in an immunocompetent adult.
[So] Source:Rinsho Shinkeigaku;57(4):174-179, 2017 04 28.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 26-year-old, otherwise healthy man presented with visual abnormality followed by loss of consciousness and convulsion. The patient then developed headache and fever 14 days later. Brain MRI showed hyperintensities in the left cingulate cortex. The cerrebrospinal fluid examinations showed mononuclear pleocytosis and positive PCR results for human herpesvirus 6 (HHV-6). A diagnosis of HHV-6 encephalitis and symptomatic epilepsy was made. The patient's clinical symptoms improved promptly following acyclovir treatment. However, 3 months later the patient noticed dysesthesia in the trunk, the left upper limb and the right lower limb. Brain and spine MRI showed multiple brain white matter lesions, the middle cerebellar peduncle and cervical spinal lesions. The symptoms resolved following methylprednisolone pulse therapy only. We report an adult patient with HHV-6 encephalitis followed by acute disseminated encephalomyelitis whose initial presentation was epilepsy. HHV-6 encephalitis should be included in the differential diagnosis of encephalitis of unknown etiology in an immunocompetent adult.
[Mh] Termos MeSH primário: Encefalite/diagnóstico
Encefalite/virologia
Encefalomielite Aguda Disseminada/etiologia
Herpesvirus Humano 6/isolamento & purificação
Imunocompetência
Infecções por Roseolovirus
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/líquido cefalorraquidiano
Encéfalo/diagnóstico por imagem
Vértebras Cervicais
Encefalite/tratamento farmacológico
Encefalomielite Aguda Disseminada/tratamento farmacológico
Epilepsia/tratamento farmacológico
Epilepsia/etiologia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Metilprednisolona/administração & dosagem
Pulsoterapia
Medula Espinal/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-000992


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[PMID]:28327523
[Au] Autor:Peschl P; Ramberger M; Höftberger R; Jöhrer K; Baumann M; Rostásy K; Reindl M
[Ad] Endereço:Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck A-6020, Austria. patrick.peschl@i-med.ac.at.
[Ti] Título:Methodological Challenges in Protein Microarray and Immunohistochemistry for the Discovery of Novel Autoantibodies in Paediatric Acute Disseminated Encephalomyelitis.
[So] Source:Int J Mol Sci;18(3), 2017 Mar 22.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune-mediated demyelinating disease affecting mainly children and young adults. Differentiation to multiple sclerosis is not always possible, due to overlapping clinical symptoms and recurrent and multiphasic forms. Until now, immunoglobulins reactive to myelin oligodendrocyte glycoprotein (MOG antibodies) have been found in a subset of patients with ADEM. However, there are still patients lacking autoantibodies, necessitating the identification of new autoantibodies as biomarkers in those patients. Therefore, we aimed to identify novel autoantibody targets in ADEM patients. Sixteen ADEM patients (11 seronegative, 5 seropositive for MOG antibodies) were analysed for potential new biomarkers, using a protein microarray and immunohistochemistry on rat brain tissue to identify antibodies against intracellular and surface neuronal and glial antigens. Nine candidate antigens were identified in the protein microarray analysis in at least two patients per group. Immunohistochemistry on rat brain tissue did not reveal new target antigens. Although no new autoantibody targets could be found here, future studies should aim to identify new biomarkers for therapeutic and prognostic purposes. The microarray analysis and immunohistochemistry methods used here have several limitations, which should be considered in future searches for biomarkers.
[Mh] Termos MeSH primário: Autoanticorpos/imunologia
Encefalomielite Aguda Disseminada/diagnóstico
Encefalomielite Aguda Disseminada/imunologia
Imuno-Histoquímica
Análise Serial de Proteínas
[Mh] Termos MeSH secundário: Animais
Autoantígenos/imunologia
Biomarcadores
Criança
Análise por Conglomerados
Reações Cruzadas/imunologia
Feminino
Seres Humanos
Masculino
Proteínas de Membrana/imunologia
Glicoproteína Mielina-Oligodendrócito/imunologia
Proteínas do Tecido Nervoso/imunologia
Proteínas/imunologia
Proteoma
Proteômica/métodos
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Autoantigens); 0 (Biomarkers); 0 (CNTNAP2 protein, human); 0 (LGI1 protein, human); 0 (Membrane Proteins); 0 (Myelin-Oligodendrocyte Glycoprotein); 0 (Nerve Tissue Proteins); 0 (Proteins); 0 (Proteome)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170420
[Lr] Data última revisão:
170420
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE



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