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Case Reports
. 2018 Dec;99(6):1419-1421.
doi: 10.4269/ajtmh.17-0938.

Case Report: Acute Transverse Myelitis after Zika Virus Infection

Vanderson Carvalho Neri  1 , Maria Filomena Xavier  2 , Priscila Oliveira Barros  3 , Cleonice Melo Bento  3 , Romain Marignier  4   5 , Regina Papais Alvarenga  2   1
Affiliations
Case Reports

Case Report: Acute Transverse Myelitis after Zika Virus Infection

Vanderson Carvalho Neri et al. Am J Trop Med Hyg. 2018 Dec.

Abstract

We report here one case of Zika virus (ZIKV) infection associated with auto-immunity directed against the central nervous system in a Brazilian woman who developed acute transverse myelitis 9 days after recovery from an acute episode of fever with generalized erythema. Imaging of the spinal cord showed an elongated area on the T1-T10 level with gadolinium uptake. The diagnostic of the ZIKV infection was confirmed by cerebrospinal fluid and serum analysis. This patient had serum positivity for autoantibodies against myelin oligodendrocyte glycoprotein (MOG), a specific antibody against the myelin sheath. We propose that a direct central nervous system infection by ZIKV could lead to a specific auto-immunity against MOG protein.

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Figures

Figure 1.
Figure 1.
Imaging of the spinal cord. (A) Magnetic resonance imaging T2 sequences showing hypersignal in the cervical spinal cord C2, C6-C7, and C7-T1. (B) The same widespread change is observed in the thoracic spinal cord, C7-T1, and T9-T10, determining expansion at some levels, suggestive of an inflammatory process. (C) After treatment with methylprednisolone for two cycles, important reduction of lesions in cervical and dorsal spinal cord was noted.
See this image and copyright information in PMC

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