Plasma Cell Cerebrospinal Fluid Pleocytosis Does Not Predict West Nile Virus Infection

Jordan, Michael; Nagpal, Avish; Newman, William P.; Thompson, Paul A.; Carson, Paul J.

doi:10.1155/2012/697418

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…The number of studies which analyze the CSF component modifications during WNV infection, or investigate the association between imbalance of CSF elements and severity of WNV infection is very limited. Some reports postulated that the number of plasma white cells in CSF could be used as an indicator of brain WNV infection [26] , [27] , but these findings were not confirmed by more recent studies [28] , [29] , suggesting that the predictive value for WNND diagnosis is low. Recently, Petzold and collaborators observed that the CSF levels of neuronal ( i.e.…”

Section: Introductionmentioning

confidence: 91%

Cerebrospinal Fluid Biomarker Candidates Associated with Human WNV Neuroinvasive Disease

et al. 2014

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During the last decade, the epidemiology of WNV in humans has changed in the southern regions of Europe, with high incidence of West Nile fever (WNF) cases, but also of West Nile neuroinvasive disease (WNND). The lack of human vaccine or specific treatment against WNV infection imparts a pressing need to characterize indicators associated with neurological involvement. By its intimacy with central nervous system (CNS) structures, modifications in the cerebrospinal fluid (CSF) composition could accurately reflect CNS pathological process. Until now, few studies investigated the association between imbalance of CSF elements and severity of WNV infection. The aim of the present study was to apply the iTRAQ technology in order to identify the CSF proteins whose abundances are modified in patients with WNND. Forty-seven proteins were found modified in the CSF of WNND patients as compared to control groups, and most of them are reported for the first time in the context of WNND. On the basis of their known biological functions, several of these proteins were associated with inflammatory response. Among them, Defensin-1 alpha (DEFA1), a protein reported with anti-viral effects, presented the highest increasing fold-change (FC>12). The augmentation of DEFA1 abundance in patients with WNND was confirmed at the CSF, but also in serum, compared to the control individual groups. Furthermore, the DEFA1 serum level was significantly elevated in WNND patients compared to subjects diagnosed for WNF. The present study provided the first insight into the potential CSF biomarkers associated with WNV neuroinvasion. Further investigation in larger cohorts with kinetic sampling could determine the usefulness of measuring DEFA1 as diagnostic or prognostic biomarker of detrimental WNND evolution.

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Section: Introductionmentioning

confidence: 91%

Cerebrospinal Fluid Biomarker Candidates Associated with Human WNV Neuroinvasive Disease

et al. 2014

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“…Different severity and involvement of the meningeal inflammation could also explain the variable cytological findings. In another study, it was found that older patients with WNV were more likely to have neutrophils in their CSF (Jordan et al, 2012). The average age of our patients with high neutrophil numbers was 8 years (4-13 years) and of those with mononuclear pleocytosis was 6.6 years (4-9 years).…”

Section: Discussionmentioning

confidence: 51%

Characterisation of the cerebrospinal fluid of horses with West Nile virus neuroinvasive disease

Kutasi

Fehér

Sárdi

et al. 2020

AVet

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West Nile virus (WNV) is a zoonotic arbovirus transmitted by mosquitoes between wild birds (natural hosts) and other vertebrates. Horses and humans are incidental, dead-end hosts, but can develop severe neurological disorders. Owing to the close contact of cerebrospinal fluid (CSF) with the extracellular fluid of the brain, the analysis of CSF composition can reflect central nervous system (CNS) impairments enabling the diagnosis and understanding of various neurodegenerative CNS disorders. Our objective was to compare the findings from the CSF samples of horses with neuroinvasive WNV infection with those of healthy controls. We compared findings from fifteen CSF samples of 13 horses with acute WNV encephalomyelitis with those of 20 healthy controls. Protein, particular enzymes and ions, glucose and lactate showed abnormal levels in a significant number of WNV cases. None of the six horses with elevated glucose concentrations survived. Rather neutrophilic than mononuclear pleocytosis was identified with WNV infection. Neutrophils probably play a role in the development of inflammatory response and brain damage. Although elevated glucose levels reliably predicted the outcome, they might be the consequence of increased plasma levels and reflect general stress rather than CNS pathophysiology. The CSF findings of WNV encephalomyelitis patients are non-specific and variable but facilitate the differential diagnosis.

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“…The significance of CSF lymphocyte predominant pleocytosis in neuroinvasive WNV is still being debated 17 18…”

Section: Discussionmentioning

confidence: 99%

West Nile virus-associated acute flaccid paralysis

Alker

2015

BMJ Case Reports

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A 43-year-old woman presented to George Washington emergency department with 48 h of new-onset inguinal pain. Physical examination revealed a diffuse maculopapular rash involving the palms and soles, as well as inguinal lymphadenopathy. The patient denied recent travel outside of Washington, DC, and had no known sick contacts. She was admitted to the hospital for observation. Within 24 h of admission she developed left lower extremity flaccid paralysis, with loss of left patellar and Achilles reflexes. cerebrospinal fluid was positive for West Nile virus IgG and IgM antibodies, so methylprednisone 125 mg intravenously two times per day was started. On day 7, the patient recovered reflexes and continued to regain strength in the left lower extremity. She was discharged on day 9 on prednisone taper, with outpatient follow-up.

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Plasma Cell Cerebrospinal Fluid Pleocytosis Does Not Predict West Nile Virus Infection

Cited by 5 publications

References 11 publications

Cerebrospinal Fluid Biomarker Candidates Associated with Human WNV Neuroinvasive Disease

Cerebrospinal Fluid Biomarker Candidates Associated with Human WNV Neuroinvasive Disease

Characterisation of the cerebrospinal fluid of horses with West Nile virus neuroinvasive disease

West Nile virus-associated acute flaccid paralysis

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