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Acute transverse myelitis and hepatitis C virus
Pasquale Annunziata1, Massimo Marroni, Daniela Francisci
1Department of Neurological Sciences and Behaviour, Centre for Research on Multiple Sclerosis and Neuroimmunological Diseases, University of Siena, Siena, Italy.
Le Infezioni in Medicina
|May 13, 2005
Summary
Hepatitis C virus (HCV) infection can rarely affect the central nervous system. This case study details acute transverse myelitis in a patient with HCV, linked to an immune response against HCV proteins in cerebrospinal fluid (CSF).
Area of Science:
- Neuroimmunology
- Virology
- Neurology
Background:
- Hepatitis C virus (HCV) primarily affects the liver, with peripheral nervous system involvement being more common than central nervous system (CNS) manifestations.
- CNS involvement in HCV infection is considered rare, with limited documented cases.
Observation:
- A case of acute transverse myelitis is presented in a woman with a history of HCV seropositivity.
- The myelitis developed four years after the initial HCV diagnosis.
Findings:
- Cerebrospinal fluid (CSF) analysis revealed intrathecal anti-HCV protein IgG.
- Immunoabsorption studies on CSF demonstrated oligoclonal IgG bands binding to HCV proteins, indicating a specific intrathecal immune response.
- This is the first reported instance of acute myelitis associated with an intrathecal immune response to HCV proteins.
Implications:
- The findings suggest a potential etiological link between HCV infection and acute transverse myelitis.
- Testing CSF for HCV RNA and related antibodies should be considered in cases of acute myelitis with unknown causes.
- This highlights the importance of considering neurological complications in HCV patients.