Neuromyelitis optica spectrum disorder and varicella-zoster infection

Machado, Catarina; Amorim, José Manuel; Rocha, Jaime; Pereira, João; Lourenço, Esmeralda; Pinho, João

doi:10.1016/j.jns.2015.09.374

Cited by 28 publications

(16 citation statements)

References 8 publications

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“…Interestingly, though most of the infectious myelitis cases reported absence of AQP4-Ab, 15,[166][167][168][169][170][171][172][173] several cases have shown that NMOSD with AQP4 can develop several days after zoster infection. [174][175][176] These findings might imply at least some pathogenic overlap between these two distinctive diseases of NMOSD and herpes zoster.…”

Section: Figure 7 Nbd Manifesting Letm and Progressive Brain Atrophymentioning

confidence: 87%

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Differential diagnosis of neuromyelitis optica spectrum disorders

Kim

Lee

et al. 2017

Ther Adv Neurol Disord

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Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients. Despite some similarity in their phenotypes, these NMOSD and NMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment. Understanding the detailed clinical, serological, radiological, and prognostic differences of these diseases will improve the proper management as well as diagnosis of patients.

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Section: Figure 7 Nbd Manifesting Letm and Progressive Brain Atrophymentioning

confidence: 87%

“…174–176 These findings might imply at least some pathogenic overlap between these two distinctive diseases of NMOSD and herpes zoster.…”

Section: Differential Diagnosis Of Nmosdmentioning

confidence: 92%

Differential diagnosis of neuromyelitis optica spectrum disorders

Kim

Lee

et al. 2017

Ther Adv Neurol Disord

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“…Several previous reports have shown a relation between NMO and VZV infection, including five AQP4-IgG-positive NMOSD cases preceded by herpes zoster infection ( Table 1). Two of them showed VZVpositivity in the CSF during the onset of VZV myelitis, with AQP4-IgG being detected only during recurrence (9,10). Two others showed VZV-negativity in the CSF and AQP4-IgGpositivity and they were diagnosed with AQP4-IgG-positive NMOSD preceded by herpes zoster (1,7).…”

Section: Discussionmentioning

confidence: 97%

“…Several reports have mentioned the relationship between NMO and VZV, but none of them investigated AQP4-IgG (7). Conversely, there have been few case reports that clearly outline the association between AQP4-IgG-positive NMOSD and herpes zoster infection (1,(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Herpes Zoster Radiculomyelitis With Aquaporin-4 Antibodies: A Case Report and Literature Review

et al. 2020

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Background: The relationship between varicella-zoster virus (VZV)-associated myelitis and aquaporin-4 immunoglobulin-G (AQP4-IgG) remains unknown.Case Report: We report a case of acute radiculomyelitis with longitudinal extensive hyperintensity signals traversing the brainstem until the upper thoracic cord in a 55-year-old healthy woman following herpes zoster infection in the left C4-T3 dermatome. VZV-specific IgG in the cerebrospinal fluid (CSF) and AQP4-IgG positivity on enzyme-linked immunosorbent assay (ELISA) were undetectable. Thus, she was diagnosed with immune-competent VZV radiculomyelitis. Forty-two months later, she experienced a relapse, and AQP4-IgG positivity was detected on ELISA. A cell-based assay (CBA) showed AQP4-IgG positivity not only at the time of recurrence but also retrospectively at 1 month after the initial symptoms. We concluded that AQP4-IgG-positive neuromyelitis optica spectrum disorder (NMOSD) was concurrent with VZV myelitis. After the second attack, she was treated with azathioprine and has had no relapse since then.Conclusion: We reported a case of VZV radiculomyelitis with confirmed concurrent AQP4-IgG positivity. NMOSD induced by herpes zoster has been recently identified, but distinguishing it from VZV myelitis can be difficult and whether these two diseases aggravate each other is unknown. Awareness of the potentially varied presentation of VZV myelitis can enable earlier recognition and proper treatment.

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“…( Fujihara, 2019a , Fujihara, 2019b , Lucchinetti et al, 2014a , Lucchinetti et al, 2014b ) Several viral infections including HIV, influenza virus, varicella zoster virus, and Epstein Barr virus, among others, have been alleged to trigger NMOSD in both immunocompetent and immunocompromised individuals. ( Lana-Peixoto et al, 2018a , Lana-Peixoto et al, 2018b , Machado et al, 2015a , Machado et al, 2015b , Mathew et al, 2019a , Mathew et al, 2019b , Sellner et al, 2010a , Sellner et al, 2010b , Tran et al, 2007a , Tran et al, 2007b ) It has recently reported a case of a young man presenting with bilateral severe optic neuritis and myelitis, determined to be simultaneously SARS-CoV-2 and MOG IgG antibody positive, i.e. a variant of NMOSD.…”

Section: Introductionmentioning

confidence: 99%