一名13岁男孩的爱泼斯坦-巴尔病毒急性脑脊髓炎

Epstein-Barr virus acute encephalomyelitis in a 13-year-old boy.

作者信息

Grillo Eugênio, da Silva Ronaldo J M, Barbato Filho Jorge H

机构信息

Department of Neurology, Joana de Gusmão Children's Hospital, Florianópolis, SC, Brazil.

出版信息

Eur J Paediatr Neurol. 2008 Sep;12(5):417-20. doi: 10.1016/j.ejpn.2007.10.016. Epub 2007 Dec 3.

DOI:10.1016/j.ejpn.2007.10.016

PMID:18054506

Abstract

The association of acute myelopathy and encephalopathy is reported in a 13-year-old boy. Signs and symptoms of infectious mononucleosis, presence of heterophile antibodies, anticapsid antibodies and Epstein-Barr virus DNA detected in cerebrospinal fluid, disclosed a primary or reactivated infection by Epstein-Barr virus. Outcome was rapid and benign with complete clinical recovery in 1 month, after pulse therapy with methylprednisolone. Epstein-Barr virus is a known agent related to acute disseminated encephalomyelitis, by immune mediated mechanisms. However, in this case, cortical involvement in magnetic resonance imaging, short time between infectious mononucleosis and central nervous system manifestations, and the presence of viral DNA in cerebrospinal fluid, raised the possibility of a direct action of the virus in central nervous system. Acute myelopathy associated to Epstein-Barr virus encephalitis has been rarely reported in children.

摘要

一名13岁男孩被报道患有急性脊髓病和脑病。传染性单核细胞增多症的体征和症状、嗜异性抗体的存在、抗衣壳抗体以及在脑脊液中检测到的爱泼斯坦-巴尔病毒DNA，揭示了爱泼斯坦-巴尔病毒的原发性或再激活感染。在接受甲泼尼龙脉冲治疗后，病情迅速好转且预后良好，1个月内临床完全康复。爱泼斯坦-巴尔病毒是一种已知的通过免疫介导机制与急性播散性脑脊髓炎相关的病原体。然而，在这种情况下，磁共振成像显示皮质受累、传染性单核细胞增多症与中枢神经系统表现之间的时间间隔较短以及脑脊液中存在病毒DNA，增加了病毒直接作用于中枢神经系统的可能性。与爱泼斯坦-巴尔病毒脑炎相关的急性脊髓病在儿童中鲜有报道。