Poster 363: Transverse Myelitis Caused by Zika Virus Infection in the Caribbean: A Case Report

Romeu-Mejia, Rafael A.; Delgado-Lebron, Joanne M.; Nadal-Ortiz, Eduardo

doi:10.1016/j.pmrj.2017.08.302

Cited by 2 publications

(2 citation statements)

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“…ZIKV-ATM and ZIKV-ADEM have rarely been reported in the American continent and the Caribbean [47][48][49][50][51][52][53][54][55][56]. We were able to find a total of 19 patients with myelitis associated with ZIKV infection [Table 2].…”

Section: Acute Transverse Myelitis (Atm) and Acute Disseminated Encephalomyelitis (Adem)mentioning

confidence: 99%

“…Acute transverse myelitis (ATM): Most patients presenting with ZIKV-ATM were men (8/12, 66.6%) with a mean age of 23 years (range 15-43) (except for an 86-year-old man [50]). The latency period between Zika symptoms and neurological manifestations ranged from 7 days to 96 days (mean 18 days).…”

Section: Acute Transverse Myelitis (Atm) and Acute Disseminated Encephalomyelitis (Adem)mentioning

confidence: 99%

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Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

Román

Anaya

Mancera-Páez

et al. 2019

Journal of the Neurological Sciences

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We review post-infectious and post-vaccination neurological syndromes involving peripheral and central nervous system (CNS) and report an illustrative case of simultaneous occurrence of Guillain-Barré syndrome (GBS), confirmed by nerve conduction velocities, plus MRI-demonstrated transverse myelitis (TM) and acute encephalitis [acute disseminated encephalomyelitis] (ADEM+GBS) affecting a 24-year-old woman from Cúcuta, Colombia, who developed acute Zika virus (ZIKV) infection confirmed by serum reverse transcriptase-polymerase chain reaction (RT-PCR) and convalescent ZIKV IgG antibodies. With intensive care treatment, respiratory support, steroids, and intravenous immunoglobulin (IVIg), patient survived with residual flaccid paraparesis. She had preexisting immunity against Chikungunya virus (CHIKV) and Dengue virus (DENV) acquired before the arrival of ZIKV in Colombia. From reports in the Caribbean, Central and South America we review 19 cases of ZIKV-associated TM, encephalitis and ADEM occurring after a mean latent period of 10.5 days (range 1-96) post-infection. Although GBS and ADEM are usually considered post-infectious and associated with development of antibodies against peripheral nerve and CNS epitopes, we postulate that our case of ADEM+GBS is para-infectious, induced by acute ZIKV neurotropism boosted by active immunity against other arboviruses. Animal models of ZIKV demonstrated strong viral neurotropism enhanced by passive immunity with antibodies against arboviruses such as West Nile virus, CHIKV, or DENV. These considerations are relevant to prevent potential ZIKV vaccine-induced reactions involving central and peripheral nervous system.cycle where transmission to humans occurs mainly by female Aedes mosquitoes-also carriers of DENV and Chikungunya (CHIKV), an alphavirus of the family Togaviridae. In addition, sexual transmission of ZIKV has been demonstrated with virus isolations from urine, semen, blood, maternal milk and tears. Zika infection is manifested by fever, maculopapular rash, conjunctivitis and rare uveitis, arthralgias, muscle pain and headache, but about 80% of infections are asymptomatic [2]. Nonetheless, ZIKV is neuroinvasive and capable of causing numerous neurological manifestations [2].According to the World Health Organization (WHO) [3], a major

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Section: Acute Transverse Myelitis (Atm) and Acute Disseminated Encephalomyelitis (Adem)mentioning

confidence: 99%

Section: Acute Transverse Myelitis (Atm) and Acute Disseminated Encephalomyelitis (Adem)mentioning

confidence: 99%

Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

Román

Anaya

Mancera-Páez

et al. 2019

Journal of the Neurological Sciences

View full text Add to dashboard Cite

show abstract

Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

Mancera-Páez

Román

Turriago

et al. 2018

Journal of the Neurological Sciences

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Poster 363: Transverse Myelitis Caused by Zika Virus Infection in the Caribbean: A Case Report

Cited by 2 publications

References 0 publications

Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: A case report and review of the pathogenic role of multiple arboviral immunity

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