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Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
Published on: July 9, 2014
IVIG treatment for VZV-related acute inflammatory polyneuropathy in a child
Danilo Buonsenso1, Benedetta Focarelli, Piero Valentini
1Department of Pediatrics, Pediatric Infectious Diseases Unit, Catholic University of the Sacred Heart, Rome, Italy.
Abstract:
Acute inflammatory polyneuropathy is an inflammatory demyelinating disease triggered by an autoimmune mechanism. It follows an infection or an immunisation after a free interval of 2-30 days. We report a case of a 14-year-old boy who develops an acute rapidly progressive paraplegia, urine incontinence and positive Lasegue a week after a characteristic chickenpox rash. Spinal MRI showed diffuse thickening and leptomeningeal enhancement of cauda equina nerve roots. Intravenous immunoglobulins were given and yielded a dramatic clinical and radiological improvement. The patient was discharged without any clinical problems 1 month after the onset of symptoms. We performed a review of the literature, discussing the different forms of varicella-zoster virus-related central and peripheral nervous system complications and management strategies for acute postinfectious encephalomyelitis/radiculitis.
Insights
A rare autoimmune complication following chickenpox caused acute paraplegia in a teen. Prompt treatment with intravenous immunoglobulins led to a full recovery, highlighting effective management of post-infectious neurological issues.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Acute inflammatory polyneuropathy is an autoimmune demyelinating disease.
- It often follows infections or immunizations after a latent period.
Observation:
- A 14-year-old boy presented with rapid paraplegia and urinary incontinence post-chickenpox.
- Spinal MRI revealed thickened, enhancing cauda equina nerve roots.
Findings:
- Intravenous immunoglobulin therapy resulted in significant clinical and radiological improvement.
- The patient recovered fully within one month.
Implications:
- This case underscores varicella-zoster virus's potential for severe neurological complications.
- Early diagnosis and treatment with immunoglobulins are crucial for favorable outcomes in acute post-infectious encephalomyelitis/radiculitis.
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