病例报告：寨卡病毒感染后急性横贯性脊髓炎。
Case Report: Acute Transverse Myelitis after Zika Virus Infection.
机构信息
Neurology Department, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Multiple Sclerosis Treatment Center, Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
出版信息
Am J Trop Med Hyg. 2018 Dec;99(6):1419-1421. doi: 10.4269/ajtmh.17-0938.
Abstract
We report here one case of Zika virus (ZIKV) infection associated with auto-immunity directed against the central nervous system in a Brazilian woman who developed acute transverse myelitis 9 days after recovery from an acute episode of fever with generalized erythema. Imaging of the spinal cord showed an elongated area on the T1-T10 level with gadolinium uptake. The diagnostic of the ZIKV infection was confirmed by cerebrospinal fluid and serum analysis. This patient had serum positivity for autoantibodies against myelin oligodendrocyte glycoprotein (MOG), a specific antibody against the myelin sheath. We propose that a direct central nervous system infection by ZIKV could lead to a specific auto-immunity against MOG protein.
摘要
我们在此报告一例与中枢神经系统自身免疫相关的寨卡病毒（ZIKV）感染病例，该病例发生于一名巴西女性，其在发热伴全身性红斑急性发作康复后 9 天出现急性横贯性脊髓炎。脊髓成像显示 T1-T10 水平有一个延长区域，钆摄取增加。通过脑脊液和血清分析确认了 ZIKV 感染的诊断。该患者血清中存在针对髓鞘少突胶质细胞糖蛋白（MOG）的自身抗体阳性，这是一种针对髓鞘的特异性抗体。我们提出，ZIKV 对中枢神经系统的直接感染可能导致针对 MOG 蛋白的特异性自身免疫。
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