Enterovirus A71 causing meningoencephalitis and acute flaccid myelitis in a patient receiving rituximab.

Adult Central Nervous System Viral Diseases / diagnostic imaging Enterovirus A, Human / isolation & purification Enterovirus Infections / diagnostic imaging Female Humans Immunologic Factors / adverse effects Meningoencephalitis / diagnostic imaging Myelitis / diagnostic imaging Neuromuscular Diseases / diagnostic imaging Rituximab / adverse effects
AFM Acute flaccid myelitis Acute flaccid paralysis Encephalitis Enterovirus Enterovirus A71 Meningitis Meningoencephalitis Poliomyelitis Rheumatoid arthritis Rituximab

Journal

Journal of neuroimmunology
ISSN: 1872-8421
Titre abrégé: J Neuroimmunol
Pays: Netherlands
ID NLM: 8109498

Informations de publication

Date de publication:
15 09 2021
Historique:
received: 12 05 2021
revised: 15 06 2021
accepted: 21 06 2021
pubmed: 3 7 2021
medline: 24 12 2021
entrez: 2 7 2021
Statut: ppublish

Résumé

We present the case of a young woman being treated with rituximab for rheumatoid arthritis who developed a severe enteroviral meningoencephalitis and acute flaccid myelitis (AFM). Cerebrospinal fluid (CSF) and stool reverse transcription-polymerase chain reaction (RT-PCR) testing confirmed the diagnosis and additional sequencing studies performed at the CDC further characterized the enterovirus as enterovirus A71 (EV-A71). After treatment with intravenous immunoglobulin (IVIg) and fluoxetine (based on previous reports of possible efficacy) the patient experienced a remarkable improvement over time. This case highlights the importance of considering enteroviral infection in patients treated with rituximab, depicts a possible clinical course of enteroviral meningoencephalitis and AFM, and illustrates the importance of testing multiple sites for enterovirus infection (CSF, stool, nasopharyngeal swab, blood). Here we present the case with a brief review of the literature pertaining to EV-A71.

Identifiants

DOI: 10.1016/j.jneuroim.2021.577639 PMID: 34214953
pubmed: 34214953
pii: S0165-5728(21)00166-1
doi: 10.1016/j.jneuroim.2021.577639
pii:
doi:

Substances chimiques

Immunologic Factors 0
Rituximab 4F4X42SYQ6

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

577639

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Ronak K Kapadia (RK)

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America; Division of Neurology, Department of Clinical Neurosciences, University of Calgary, Cummings School of Medicine, Calgary, Alberta, Canada.

Christine M Gill (CM)

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America.

Christine Baca (C)

Department of Neurology, University of Colorado, Aurora, CO, United States of America.

Constance McMenamin (C)

Department of Neurology, University of Colorado, Aurora, CO, United States of America.

Arun Kannappan (A)

Department of Pulmonary Sciences and Critical Care, University of Colorado, Aurora, CO, United States of America.

William N Niehaus (WN)

Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, United States of America.

Kenneth L Tyler (KL)

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America.

Daniel M Pastula (DM)

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America.

Amanda L Piquet (AL)

Neuro-Infectious Diseases Group, Department of Neurology, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, United States of America; Department of Neurology, University of Colorado, Aurora, CO, United States of America. Electronic address: Amanda.Piquet@cuanschutz.edu.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Infections du système nerveux central › Maladies virales du système nerveux central › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Picornaviridae › Enterovirus › Entérovirus humain A › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Infection › Maladies virales › Infections à virus à ARN › Infections à Picornaviridae › Infections à entérovirus › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Facteurs immunologiques › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Maladies du système nerveux › Méningite › Méningoencéphalite › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Maladies du système nerveux › Myélite › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Maladies du système nerveux › Maladies neuromusculaires › Enterovirus A71 causing meningoencephalitis...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux d'origine murine › Rituximab › Enterovirus A71 causing meningoencephalitis...