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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Vydané v:	Neurology Ročník 73; číslo 17; s. 1413
Hlavní autori:	Puccioni-Sohler, M, Soares, C N, Papaiz-Alvarenga, R, Castro, M J C, Faria, L C, Peralta, J M
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 27.10.2009
Predmet:	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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Shrnutí:	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.
Bibliografia:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1526-632X 1526-632X
DOI:	10.1212/WNL.0b013e3181bd8258