Refractory acute disseminated encephalomyelitis with anti-galactocerebroside antibody

Samukawa, Makoto; Hirano, Minoru; Tsugawa, Jun; Sakamoto, Hikaru; Tabata, Emi; Takada, Kazuo; Kuwahara, Motoi; Suzuki, Shigenori; Kitada, Mari; Yamada, Tatsuo; Hara, Hideo; Tsuboi, Yoshio; Nakamura, Yusaku; Kusunoki, Susumu

doi:10.1016/j.neures.2012.09.006

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…This is supported by the kinetics of anti‐GalC antibodies in the index case, where decreasing levels correlated with clinical improvement. Anti‐GalC antibodies indeed caused demyelination in vitro and in experimental allergic neuritis and have also been associated with demyelination in GBS, encephalitis, and acute disseminated encephalomyelitis . In the current study, there was no significant difference in demyelinating features between anti‐GalC‐positive and ‐negative patients, possibly because demyelination was the major electrophysiological feature .…”

Section: Discussionsupporting

confidence: 40%

Mycoplasma pneumoniae triggering the Guillain‐Barré syndrome: A case‐control study

Sauteur

Huizinga

Tio‐Gillen

et al. 2016

Annals of Neurology

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Section: Discussionsupporting

confidence: 40%

Mycoplasma pneumoniae triggering the Guillain‐Barré syndrome: A case‐control study

Sauteur

Huizinga

Tio‐Gillen

et al. 2016

Annals of Neurology

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“…In fact, antibodies against M. pneumoniae infection have been found to cross-react with GalC in GBS patients ( Kusunoki et al, 2001 ; Ang et al, 2002 ). Moreover, anti-GalC antibodies caused demyelinating neuropathy in rabbits ( Saida et al, 1979 ) and have been associated with demyelination in GBS ( Ang et al, 2002 ), but also in encephalitis ( Christie et al, 2007b ) and encephalomyelitis ( Samukawa et al, 2012 ). The detection of intrathecal antibodies against M. pneumoniae and GalC may also be regarded as a promising new diagnostic tool for M. pneumoniae -associated CNS disease ( Meyer Sauteur et al, 2014b , 2015b ).…”

Section: Infectionmentioning

confidence: 99%

Infection with and Carriage of Mycoplasma pneumoniae in Children

et al. 2016

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“Atypical” pneumonia was described as a distinct and mild form of community-acquired pneumonia (CAP) already before Mycoplasma pneumoniae had been discovered and recognized as its cause. M. pneumoniae is detected in CAP patients most frequently among school-aged children from 5 to 15 years of age, with a decline after adolescence and tapering off in adulthood. Detection rates by polymerase chain reaction (PCR) or serology in children with CAP admitted to the hospital amount 4–39%. Although the infection is generally mild and self-limiting, patients of every age can develop severe or extrapulmonary disease. Recent studies indicate that high rates of healthy children carry M. pneumoniae in the upper respiratory tract and that current diagnostic PCR or serology cannot discriminate between M. pneumoniae infection and carriage. Further, symptoms and radiologic features are not specific for M. pneumoniae infection. Thus, patients may be unnecessarily treated with antimicrobials against M. pneumoniae. Macrolides are the first-line antibiotics for this entity in children younger than 8 years of age. Overall macrolides are extensively used worldwide, and this has led to the emergence of macrolide-resistant M. pneumoniae, which may be associated with severe clinical features and more extrapulmonary complications. This review focuses on the characteristics of M. pneumoniae infections in children, and exemplifies that simple clinical decision rules may help identifying children at high risk for CAP due to M. pneumoniae. This may aid physicians in prescribing appropriate first-line antibiotics, since current diagnostic tests for M. pneumoniae infection are not reliably predictive.

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“…In patients with GBS, serum antibodies to M. pneumoniae have been found to cross react with the myelin glycolipid galactocerebroside (GalC) (Kusunoki et al ., ) . These anti‐GalC antibodies caused demyelinating neuropathy in rabbits that were immunised with GalC (Saida et al ., ) and have also been associated with demyelination in GBS (Ang et al ., ) , encephalitis (Christie et al ., ) , and acute disseminated encephalomyelitis (Samukawa et al ., ) .…”

Section: Discussionmentioning

confidence: 97%

Severe childhood Guillain‐Barré syndrome associated with Mycoplasma pneumoniae infection: a case series

Sauteur

Roodbol

Hackenberg

et al. 2015

J Peripheral Nervous Sys

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We report seven children with recent Mycoplasma pneumoniae infection and severe Guillain-Barré syndrome (GBS) that presented to two European medical centres from 1992 to 2012. Severe GBS was defined as the occurrence of respiratory failure, central nervous system (CNS) involvement, or death. Five children had GBS, one Bickerstaff brain stem encephalitis (BBE), and one acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). The five patients with severe GBS were derived from an original cohort of 66 children with GBS. In this cohort, 17 children (26%) had a severe form of GBS and 47% of patients with M. pneumoniae infection presented with severe GBS. Of the seven patients in this case series, five were mechanically ventilated and four had CNS involvement (two were comatose). Most patients presented with non-specific clinical symptoms (nuchal rigidity and ataxia) and showed a rapidly progressive disease course (71%). Antibodies against M. pneumoniae were detected in all patients and were found to be intrathecally synthesised in two cases (GBS and BBE), which proves intrathecal infection. One patient died and only two patients recovered completely. These cases illustrate that M. pneumoniae infection in children can be followed by severe and complicated forms of GBS. Non-specific clinical features of GBS in such patients may predispose a potentially life-threatening delay in diagnosis.

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Refractory acute disseminated encephalomyelitis with anti-galactocerebroside antibody

Cited by 17 publications

References 16 publications

Mycoplasma pneumoniae triggering the Guillain‐Barré syndrome: A case‐control study

Mycoplasma pneumoniae triggering the Guillain‐Barré syndrome: A case‐control study

Infection with and Carriage of Mycoplasma pneumoniae in Children

Severe childhood Guillain‐Barré syndrome associated with Mycoplasma pneumoniae infection: a case series

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