COVID-19, HHV6 and MOG antibody: A perfect storm.
Anti-Inflammatory Agents
/ therapeutic use
Antiviral Agents
/ therapeutic use
Autoantibodies
/ immunology
Autoantigens
/ immunology
COVID-19
/ complications
Coinfection
/ complications
Ganciclovir
/ therapeutic use
Herpesvirus 6, Human
Humans
Lymphopenia
/ virology
Male
Methylprednisolone
/ therapeutic use
Middle Aged
Myelitis, Transverse
/ immunology
Plasma Exchange
/ methods
Roseolovirus Infections
/ drug therapy
SARS-CoV-2
Virus Activation
/ immunology
COVID-19
Demyelination
HHV6
MOG
SARS-CoV-2
Transverse myelitis
Journal
Journal of neuroimmunology
ISSN: 1872-8421
Titre abrégé: J Neuroimmunol
Pays: Netherlands
ID NLM: 8109498
Informations de publication
Date de publication:
15 04 2021
15 04 2021
Historique:
received:
18
12
2020
revised:
06
02
2021
accepted:
06
02
2021
pubmed:
20
2
2021
medline:
26
3
2021
entrez:
19
2
2021
Statut:
ppublish
Résumé
Serious neurological complications of SARS-CoV-2 are increasingly being recognized. We report a novel case of HHV6 myelitis with parainfectious MOG-IgG in the setting of COVID-19-induced lymphopenia and hypogammaglobulinemia. The patient experienced complete neurological recovery with gancyclovir, high dose corticosteroids, and plasma exchange. To our knowledge, this is the first case of HHV6 reactivation in the central nervous system in the setting of COVID19 infection and the first case of MOG-IgG myelitis in the setting of SARS-CoV-2 and HHV6 coinfection. Patients with neurological manifestations in the setting of COVID19-related immunodeficiency should be tested for opportunistic infections including HHV6. Viral infection is a known trigger for MOG-IgG and therefore this antibody should be checked in patients with SARS-CoV-2 associated demyelination.
Sections du résumé
BACKGROUND
Serious neurological complications of SARS-CoV-2 are increasingly being recognized.
CASE
We report a novel case of HHV6 myelitis with parainfectious MOG-IgG in the setting of COVID-19-induced lymphopenia and hypogammaglobulinemia. The patient experienced complete neurological recovery with gancyclovir, high dose corticosteroids, and plasma exchange. To our knowledge, this is the first case of HHV6 reactivation in the central nervous system in the setting of COVID19 infection and the first case of MOG-IgG myelitis in the setting of SARS-CoV-2 and HHV6 coinfection.
CONCLUSION
Patients with neurological manifestations in the setting of COVID19-related immunodeficiency should be tested for opportunistic infections including HHV6. Viral infection is a known trigger for MOG-IgG and therefore this antibody should be checked in patients with SARS-CoV-2 associated demyelination.
Identifiants
pubmed: 33607505
pii: S0165-5728(21)00048-5
doi: 10.1016/j.jneuroim.2021.577521
pmc: PMC7879032
pii:
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Antiviral Agents
0
Autoantibodies
0
Autoantigens
0
Ganciclovir
P9G3CKZ4P5
Methylprednisolone
X4W7ZR7023
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
577521Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.