A Case of Acute Disseminated Encephalomyelitis Associated with Hepatitis C Virus Infection

Sim, Jae Sung; Lee, Jun-Bum; Cho, Yu Na; Suh, Sang Hyun; Kim, Ja Kyung; Lee, Ki Young

doi:10.3349/ymj.2012.53.4.856

Cited by 15 publications

(11 citation statements)

References 10 publications

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“…Chronic HCV has also been associated with severe encephalomyelitis [23,24] . Magnetic resonance imaging (MRI) reports point toward CNS injuries in the cerebral and cerebellar white matter.…”

Section: Cns Involvement In Hcv Infectionmentioning

confidence: 99%

Hepatitis C virus and neurological damage

Mathew

Faheem

Ibrahim

et al. 2016

WJH

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Author contributions: Mathew S and Faheem M contributed equally to this manuscript; Qadri I conceived and designed the topic; Mathew S, Faheem M, Ibrahim SM, Iqbal W and Rauff B contributed to materials and wrote the paper; Faheem M, Ibrahim SM, Iqbal W, Rauff B, Fatima K and Qadri I contributed to proof reading of the manuscript.Supported by KACST large R and D grant to Ishtiaq Qadri (#162-34).Conflict-of-interest statement: Authors declare no conflict of interests for this article. AbstractChronic hepatitis C virus (HCV) infection exhibits a wide range of extrahepatic complications, affecting various organs in the human body. Numerous HCV patients suffer neurological manifestations, ranging from cognitive impairment to peripheral neuropathy. Overexpression of the host immune response leads to the production of immune complexes, cryoglobulins, as well as autoantibodies, which is a major pathogenic mechanism responsible for nervous system dysfunction. Alternatively circulating inflammatory cytokines and chemokines and HCV replication in neurons is another factor that severely affects the nervous system. Furthermore, HCV infection causes both sensory and motor peripheral neuropathy in the mixed cryoglobulinemia as well as known as an important risk aspect for stroke. These extrahepatic manifestations are the reason behind underlying hepatic encephalopathy and chronic liver disease. The brain is an apt location for HCV replication, where the HCV virus may directly wield neurotoxicity. Other mechanisms that takes place by chronic HCV infection due the pathogenesis of neuropsychiatric disorders includes derangement of metabolic pathways of infected cells, autoimmune disorders, systemic or cerebral inflammation and alterations in neurotransmitter circuits. HCV and its pathogenic role is suggested by enhancement of psychiatric and neurological symptoms in patients attaining a sustained virologic response followed by treatment with interferon; however, further studies are required to fully assess the impact of HCV infection and its specific antiviral targets associated with neuropsychiatric disorders. REVIEWSubmit a

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Section: Cns Involvement In Hcv Infectionmentioning

confidence: 99%

Hepatitis C virus and neurological damage

Mathew

Faheem

Ibrahim

et al. 2016

WJH

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“…Hepatitis C virus infection has been linked to various autoimmune disorders [10], including ADEM [11,12]. Sacconi et al reported the case of a 46-year-old woman who presented with altered mental status, seizures, hemiparesis and hemianopia seven weeks after surgery and blood transfusion.…”

Section: Discussionmentioning

confidence: 97%

“…MRI showed multiple brainstem, thalamic, and cord lesions consistent with ADEM. Serum and CSF anti-HCV antibody tests were positive and PCR showed markedly elevated HCV RNA titer [12]. Prior to these reports, HCV-related CNS inflammation was attributed to CNS vasculitis in the setting of cryoglobulinemia [13].…”

Section: Discussionmentioning

confidence: 97%

Tumefactive multiple sclerosis and hepatitis C virus 2a/2C infection: Dual benefit of long-term interferon beta-1a therapy?

Mader

Richeh

Ochoa

et al. 2015

Journal of the Neurological Sciences

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“…The brain biopsy showed active demyelination and perivascular inflammatory infiltrates. Acute disseminated encephalomyelitis (ADEM) has been reported in association with an acute systemic HCV infection with anti-HCV IgM antibodies [86] and in chronic hepatitis in which the anti-HCV antibody was detected in the CSF [87]. In both cases, patients improved with steroid treatment.…”

Section: Central Nervous System Disorders With Hepatitis C Infectionmentioning

confidence: 97%

Neurological Complications of Hepatitis C Infection

McCarthy

Ortega

2012

Curr Neurol Neurosci Rep

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Though well-known as a cause of liver disease, Hepatitis C virus infection is emerging as a cause of a variety of peripheral and central nervous system disorders. The virus causes chronic persistent infection with complex immune responses in the majority of individuals. Viral infection may have the potential to generate neurological illness through direct infection of neural cells or through immune-mediated mechanisms, including enhancement of autoimmune responses. Moreover, the mainstay of antiviral treatment of hepatitis C infection, interferon-alpha, is itself associated with neurological morbidity. Thus neurologists are increasingly faced with diagnosing or even predicting a wide spectrum of neurological complications of hepatitis C infection and/or its treatment.

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A Case of Acute Disseminated Encephalomyelitis Associated with Hepatitis C Virus Infection

Cited by 15 publications

References 10 publications

Hepatitis C virus and neurological damage

Hepatitis C virus and neurological damage

Tumefactive multiple sclerosis and hepatitis C virus 2a/2C infection: Dual benefit of long-term interferon beta-1a therapy?

Neurological Complications of Hepatitis C Infection

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