Chronic Dengue Virus Panencephalitis in a Patient with Progressive Dementia with Extrapyramidal Features.
Journal
Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
27
06
2019
revised:
16
08
2019
accepted:
25
08
2019
pubmed:
29
8
2019
medline:
9
4
2020
entrez:
29
8
2019
Statut:
ppublish
Résumé
To determine the underlying etiology in a patient with progressive dementia with extrapyramidal signs and chronic inflammation referred to the National Institutes of Health Undiagnosed Diseases Program. Extensive investigations included metabolic profile, autoantibody panel, infectious etiologies, genetic screening, whole exome sequencing, and the phage-display assay, VirScan, for viral immune responses. An etiological diagnosis was established postmortem. Using VirScan, enrichment of dengue viral antibodies was detected in cerebrospinal fluid as compared to serum. No virus was detected in serum or cerebrospinal fluid, but postmortem analysis confirmed dengue virus in the brain by immunohistochemistry, in situ hybridization, quantitative polymerase chain reaction, and sequencing. Dengue virus was also detectable by polymerase chain reaction and sequencing from brain biopsy tissue collected 33 months antemortem, confirming a chronic infection despite a robust immune response directed against the virus. Immunoprofiling and whole exome sequencing of the patient did not reveal any immunodeficiency, and sequencing of the virus demonstrated wild-type dengue virus in the central nervous system. Dengue virus is the most common arbovirus worldwide and represents a significant public health concern. Infections with dengue virus are usually self-limiting, and chronic dengue infections have not been previously reported. Our findings suggest that dengue virus infections may persist in the central nervous system causing a panencephalitis and should be considered in patients with progressive dementia with extrapyramidal features in endemic regions or with relevant travel history. Furthermore, this work highlights the utility of comprehensive antibody profiling assays to aid in the diagnosis of encephalitis of unknown etiology. ANN NEUROL 2019;86:695-703.
Types de publication
Case Reports
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
695-703Subventions
Organisme : NINDS NIH HHS
ID : NS003130
Pays : United States
Informations de copyright
Published 2019. This article is a U.S. Government work and is in the public domain in the USA.
Références
Bhatt S, Gething PW, Brady OJ, et al. The global distribution and burden of dengue. Nature 2013;496:504-507.
Burke DS, Nisalak A, Johnson DE, Scott RM. A prospective study of dengue infections in Bangkok. Am J Trop Med Hyg 1988;38:172-180.
Guzman MG, Gubler DJ, Izquierdo A, et al. Dengue infection. Nat Rev Dis Primers 2016;2:16055.
Carod-Artal FJ, Wichmann O, Farrar J, Gascon J. Neurological complications of dengue virus infection. Lancet Neurol 2013;12:906-919.
Araujo FM, Brilhante RS, Cavalcanti LP, et al. Detection of the dengue non-structural 1 antigen in cerebral spinal fluid samples using a commercially available enzyme-linked immunosorbent assay. J Virol Methods 2011;177:128-131.
Domingues RB, Kuster GW, Onuki-Castro FL, et al. Involvement of the central nervous system in patients with dengue virus infection. J Neurol Sci 2008;267:36-40.
Li HM, Huang YK, Su YC, Kao CH. Increased risk of autoimmune diseases in dengue patients: a population-based cohort study. J Infect 2018;77:212-219.
Puccioni-Sohler M, Ornelas AMM, de Souza AS, et al. First report of persistent dengue-1-associated autoimmune neurological disturbance: neuromyelitis optica spectrum disorder. J Neurovirol 2017;23:768-771.
Mohan D, Wansley DL, Sie BM, et al. PhIP-Seq characterization of serum antibodies using oligonucleotide-encoded peptidomes. Nat Protoc 2018;13:1958-1978.
Larman HB, Zhao Z, Laserson U, et al. Autoantigen discovery with a synthetic human peptidome. Nat Biotechnol 2011;29:535-541.
Xu GJ, Kula T, Xu Q, et al. Comprehensive serological profiling of human populations using a synthetic human virome. Science 2015;348:aaa0698.
Yuan T, Mohan D, Laserson U, et al. Improved analysis of phage immunoprecipitation sequencing (PhIP-Seq) data using a z-score algorithm. 2018. bioRxiv 285916; doi: https://doi.org/10.1101/285916.
Monaco DR, Kottapalli SV, Yuan T, et al. Deconvoluting virome-wide antiviral antibody profiling data. 2018. bioRxiv 333625; doi: https://doi.org/10.1101/333625.
Kirkpatrick BD, Durbin AP, Pierce KK, et al. Robust and balanced immune responses to all 4 dengue virus serotypes following administration of a single dose of a live attenuated tetravalent dengue vaccine to healthy, flavivirus-naive adults. J Infect Dis 2015;212:702-710.
Alm E, Lesko B, Lindegren G, et al. Universal single-probe RT-PCR assay for diagnosis of dengue virus infections. PLoS Negl Trop Dis 2014;8:e3416.
Gahl WA, Mulvihill JJ, Toro C, et al. The NIH Undiagnosed Diseases Program and Network: applications to modern medicine. Mol Genet Metab 2016;117:393-400.
National Institute of Neurological Disorders and Stroke. Meningitis and encephalitis fact sheet. Updated April 2004. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Meningitis-and-Encephalitis-Fact-Sheet. Accessed April 18, 2018.
Aid M, Abbink P, Larocca RA, et al. Zika virus persistence in the central nervous system and lymph nodes of Rhesus monkeys. Cell 2017;169:610-620.e14.
Bopeththa B, Ralapanawa U. Post encephalitic parkinsonism following dengue viral infection. BMC Res Notes 2017;10:655.
Chakravarti A, Chauhan MS, Kumar S, Ashraf A. Genotypic characterization of dengue virus strains circulating during 2007-2009 in New Delhi. Arch Virol 2013;158:571-581.
Chakravarti A, Kumar A, Matlani M. Displacement of dengue virus type 3 and type 2 by dengue virus type 1 in Delhi during 2008. Indian J Med Microbiol 2010;28:412.
Beltramello M, Williams KL, Simmons CP, et al. The human immune response to Dengue virus is dominated by highly cross-reactive antibodies endowed with neutralizing and enhancing activity. Cell Host Microbe 2010;8:271-283.
Dhole P, Nakayama EE, Saito A, et al. Sequence diversity of dengue virus type 2 in brain and thymus of infected interferon receptor ko mice: implications for dengue virulence. Virol J 2016;13:199.
Wang WK, Chen HL, Yang CF, et al. Slower rates of clearance of viral load and virus-containing immune complexes in patients with dengue hemorrhagic fever. Clin Infect Dis 2006;43:1023-1030.
Iannetta M, Lalle E, Musso M, et al. Persistent detection of dengue virus RNA in vaginal secretion of a woman returning from Sri Lanka to Italy, April 2017. Euro Surveill 2017;22(34).
Murray KO, Kolodziej S, Ronca SE, et al. Visualization of West Nile virus in urine sediment using electron microscopy and immunogold up to nine years postinfection. Am J Trop Med Hyg 2017;97:1913-1919.
Murray K, Walker C, Herrington E, et al. Persistent infection with West Nile virus years after initial infection. J Infect Dis 2010;201:2-4.
Paz-Bailey G, Rosenberg ES, Doyle K, et al. Persistence of Zika virus in body fluids-preliminary report. N Engl J Med 2017;379:1234-1243.
Raut R, Corbett KS, Tennekoon RN, et al. Dengue type 1 viruses circulating in humans are highly infectious and poorly neutralized by human antibodies. Proc Natl Acad Sci U S A 2019;116:227-232.
Gadoth N. Subacute sclerosing panencephalitis (SSPE) the story of a vanishing disease. Brain Dev 2012;34:705-711.
Rammohan KW, McFarland HF, McFarlin DE. Induction of subacute murine measles encephalitis by monoclonal antibody to virus haemagglutinin. Nature 1981;290:588-589.
Wang TT, Sewatanon J, Memoli MJ, et al. IgG antibodies to dengue enhanced for FcgammaRIIIA binding determine disease severity. Science 2017;355:395-398.
Katzelnick LC, Gresh L, Halloran ME, et al. Antibody-dependent enhancement of severe dengue disease in humans. Science 2017;358:929-932.
Ehrengruber MU, Ehler E, Billeter MA, Naim HY. Measles virus spreads in rat hippocampal neurons by cell-to-cell contact and in a polarized fashion. J Virol 2002;76:5720-5728.
Cattaneo R, Schmid A, Spielhofer P, et al. Mutated and hypermutated genes of persistent measles viruses which caused lethal human brain diseases. Virology 1989;173:415-425.
Rima BK, Duprex WP. Molecular mechanisms of measles virus persistence. Virus Res 2005;111:132-147.
Diosa-Toro M, Troost B, van de Pol D, et al. Tomatidine, a novel antiviral compound towards dengue virus. Antiviral Res 2018;161:90-99.