Acute Disseminated Encephalomyelitis Associated with Epstein-Barr Viral Infection
| Autor: | Hiroshi Makise, Kei Yamazaki, Takashi Kameue, Izumi Matsubara |
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| Rok vydání: | 2000 |
| Předmět: | |
| Zdroj: | Nihon Kyukyu Igakukai Zasshi. 11:660-664 |
| ISSN: | 1883-3772 0915-924X |
| Popis: | We report a case of acute disseminated encephalomyelitis (ADEM) associated with Epstein-Barr viral (EBV) infection. A 20-year-old woman had a cough and unusual fatigue. She was admitted comatose to a hospital 3 days later. Six days after that, she was reffered to our hospital due to sustained coma and respiratory failure. She was admitted to the intensive care unit for ventilatory support. Magnetic resonance imaging (MRI) of the brain showed a large hyperintense lesion in the frontoparietal subcortical white matter in T2 weighted images. Based on clinical and radiographic data, we diagnosed ADEM. She was treated with high-dose methylprednisolone (1g/day) for 3 days and immunoadsorption plasmapheresis for 7 days. Serologic examination showed high titers for IgM viral capsid antigen (VCA-IgM) and negative results for EBV nuclear antigen (EBNA). Blood and cerebrospinal fluid (CSF) polymerase chain reaction (PCR) studies were positive for EBV. Her neurological findings did not markedly improve during her ICU stay. On day 120, she remained hospitalized due to aphasia and muscle atrophy. Follow-up MRI showed mild residual signal intensity of the lesion and enlargement of the ventricular system and cortical sulci. This case demonstrates the severe results of ADEM triggered by EBV and evidence of viral DNA in the CSF. |
| Databáze: | OpenAIRE |
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