Neurologic dengue manifestations associated with intrathecal specific immune response

Dengue infection is caused by a flavivirus, with 4 virus serotypes (types 1 to 4). The serotypes 2 and 3 represent the principal agents related to nervous system involvement. Neurologic involvement occurs in 4%-5% of dengue infection cases. The major mechanisms of the disease may be related to direc...

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Veröffentlicht in:Neurology Jg. 73; H. 17; S. 1413
Hauptverfasser: Puccioni-Sohler, M, Soares, C N, Papaiz-Alvarenga, R, Castro, M J C, Faria, L C, Peralta, J M
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 27.10.2009
Schlagworte:
Adult
Aged
Antibodies, Viral - blood
Antibodies, Viral - cerebrospinal fluid
Dengue - blood
Dengue - cerebrospinal fluid
Dengue - immunology
Dengue Virus - immunology
Encephalitis, Viral - blood
Encephalitis, Viral - cerebrospinal fluid
Encephalitis, Viral - immunology
Enzyme-Linked Immunosorbent Assay
Female
Guillain-Barre Syndrome - blood
Guillain-Barre Syndrome - cerebrospinal fluid
Guillain-Barre Syndrome - immunology
Humans
Immunoglobulin G - blood
Immunoglobulin G - cerebrospinal fluid
Immunoglobulin M - blood
Immunoglobulin M - cerebrospinal fluid
Male
Middle Aged
Myelitis - blood
Myelitis - cerebrospinal fluid
Myelitis - immunology
Optic Neuritis - blood
Optic Neuritis - cerebrospinal fluid
Optic Neuritis - immunology
Retrospective Studies
Young Adult
ISSN:1526-632X, 1526-632X
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Zusammenfassung:Dengue infection is caused by a flavivirus, with 4 virus serotypes (types 1 to 4). The serotypes 2 and 3 represent the principal agents related to nervous system involvement. Neurologic involvement occurs in 4%-5% of dengue infection cases. The major mechanisms of the disease may be related to direct viral infection or postinfectious autoimmune process. The detection of intrathecal synthesis of specific antibodies has been used to support neurologic diagnosis as a proof of local reaction. It may be quantitatively calculated by the specific antibody index. To determine if patients with neurologic manifestations associated with dengue produce specific antibodies in the CNS and to determine the antibodies' clinical and pathophysiologic relevance. CSF and serum were evaluated for dengue immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies by ELISA and for intrathecal synthesis of IgG antibodies to the dengue virus. Subjects included 10 patients IgM seropositive for dengue virus diagnosed with myelitis, encephalitis, optic neuromyelitis, or Guillain-Barré syndrome. All patients had IgG and IgM antibodies to dengue virus in their sera; 7 were IgM positive and 9 were IgG positive for dengue virus in CSF. Only the 3 patients with myelitis had intrathecal synthesis of specific IgG antibodies. Intrathecal synthesis of antibodies to dengue virus occurs in the CNS. It may be used as a marker of myelitis associated with dengue, and it seems to be related to the pathogenesis of spinal cord disease due to direct viral invasion.
Bibliographie:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0b013e3181bd8258