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Spencer D, Vela-Duarte D, Sandrian M, Bonwit AW, Schnitzler E, Prabhu VC. Fulminant acute disseminated encephalomyelitis in renal transplant patient treated by decompressive craniectomy: a case report. ACTA ACUST UNITED AC 2014. [DOI: 10.7243/2052-6946-2-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Caucheteux N, Maarouf A, Daelman L, Toupance O, Lavaud S, Tourbah A. Acute disseminated encephalomyelitis in two renal transplant patients: is there a role for Epstein-Barr virus reactivation? Mult Scler 2013; 19:1222-5. [DOI: 10.1177/1352458513478674] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory demyelinating disease of the central nervous system, usually occurring after a vaccination or infectious disease. It has been exceptionally described in transplanted patients. The pathophysiology remains incompletely understood. We report the clinical, biological and magnetic resonance imaging (MRI) presentation and evolution of two kidney-transplanted patients with ADEM associated with local Epstein-Barr virus (EBV) reactivation. ADEM may occur in transplanted patients with favorable evolution. Its pathophysiology is uncertain, and the implication of EBV is discussed.
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Affiliation(s)
| | - A Maarouf
- Department of Neurology, CHU Reims, France
| | - L Daelman
- Department of Neurology, CHU Reims, France
- Faculty of Medicine, University of Reims Champagne-Ardenne (URCA), France
| | - O Toupance
- Department of Nephrology, CHU Reims, France
| | - S Lavaud
- Department of Nephrology, CHU Reims, France
| | - A Tourbah
- Department of Neurology, CHU Reims, France
- Faculty of Medicine, University of Reims Champagne-Ardenne (URCA), France
- Laboratory of Psychopathology and Neuropsychology, University Paris VIII, France
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Bhosale GP, Shah VR, Trivedi HL. Successful renal transplantation after recovery from acute disseminated encephalomyelitis in a child with end-stage renal disease. Indian J Crit Care Med 2011; 14:101-3. [PMID: 20859497 PMCID: PMC2936728 DOI: 10.4103/0972-5229.68228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Acute disseminated encephalomyelitis (ADEM), seen mostly in children, is an acute demyelinating disease, affecting mainly the white matter of brain and spinal cord. We report an unusual case of ADEM in an 11-year old boy with endstage renal disease, who underwent hemopoietic stem cell transplantation prior to renal transplantation. He needed admission to the intensive care unit and required mechanical ventilation. He responded to intravenous injection of steroids and upon recovery, underwent renal transplantation successfully.
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Affiliation(s)
- Guruprasad P Bhosale
- Department of Anesthesia and Critical Care, Smt. G. R. Doshi and Smt. K. M. Mehta Institute of Kidney Diseases and Research Centre & Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat - 380 016, India
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Wang J, Duan S, Zhao J, Zhang L. Acute disseminated encephalomyelitis associated with Influenza A H1N1 infection. Neurol Sci 2011; 32:907-9. [PMID: 21384278 DOI: 10.1007/s10072-011-0500-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Accepted: 02/16/2011] [Indexed: 10/18/2022]
Abstract
Previous studies had not suggested acute disseminated encephalomyelitis (ADEM) during Influenza A H1N1 infection. We report the case of patient who had predominant neurological complication following Influenza A H1N1 infection. The patient, who showed clinical and MRI evidence of ADEM, had significant recovery, which in part, may be related to early treatment. The patient demonstrated that the prognosis of Influenza A H1N1-associated ADEM may not be poor.
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Affiliation(s)
- Jianxiu Wang
- Department of Neurology, The First Clinical College of Harbin Medical University, Harbin, 150001 Heilongjiang, People's Republic of China
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Brinar VV, Habek M. Diagnostic imaging in acute disseminated encephalomyelitis. Expert Rev Neurother 2010; 10:459-67. [PMID: 20187866 DOI: 10.1586/ern.10.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acute disseminated encephalomyelitis is an idiopathic inflammatory demyelinating disease of the CNS that is particularly difficult to differentiate from the first episode of multiple sclerosis, so called clinically isolated syndrome. Currently, no diagnostic criteria exist that could reliably differentiate these two diseases. More importantly no single clinical, neuroimaging or cerebrospinal fluid feature defines a disorder with absolute certainty. This review will summarize clinical and paraclinical characteristics of acute disseminated encephalomyelitis in adults, with special emphasis on diagnostic imaging.
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Affiliation(s)
- Vesna V Brinar
- University of Zagreb, School of Medicine and University Hospital Centre Zagreb, Department of Neurology and Referral Center for Demyelinating Diseases of the Central Nervous System, Zagreb, Croatia.
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Vaglio A, Manenti L, Mancini C, Chierici E, Cobelli R, Bacci F, Palmisano A, Buzio C, Bignardi L, Maggiore U. EBV-associated leukoencephalopathy with late onset of central nervous system lymphoma in a kidney transplant recipient. Am J Transplant 2010; 10:947-951. [PMID: 20420644 DOI: 10.1111/j.1600-6143.2009.02999.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Central nervous system (CNS) lymphoma is a rare posttransplant lymphoproliferative disorder (PTLD), which usually has a poor outcome. To date, no specific conditions predisposing to this complication have been identified. We here describe the case of a renal transplant patient who was initially diagnosed as having Epstein-Barr virus (EBV)-associated leukoencephalopathy and ultimately developed EBV-positive CNS lymphoma. The patient was a young lady who, 2 years after transplantation, presented with focal neurological and electroencephalographic abnormalities and diffuse white matter lesions on brain magnetic resonance imaging. EBV-DNA was detected in the cerebrospinal fluid (CSF) by polymerase chain reaction. After acyclovir therapy and immunosuppressive drug tapering, the symptoms and electroencephalographic abnormalities subsided, and EBV-DNA disappeared from the CSF. Ten years later, a bulky cerebral mass was found. After excision, a diagnosis of EBV-positive, Hodgkin-like monomorphic B-cell PTLD was made. This case illustrates the potential pathophysiological relationships between EBV infection, leukoencephalopathy and CNS lymphoma; although a long time elapsed from the initial neurological illness to CNS lymphoma, a link between these two conditions cannot be excluded. Therefore, a careful long-term follow-up of EBV-related encephalopathy is advisable.
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Affiliation(s)
- A Vaglio
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy
| | - L Manenti
- Division of Nephrology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - C Mancini
- Department of Pathology and Laboratory Medicine, Section of Pathology, University of Parma, Italy
| | - E Chierici
- Division of Neurology, Vaio Hospital, Fidenza, Italy
| | - R Cobelli
- Department of Radiology, University of Parma, Parma, Italy
| | - F Bacci
- Institute of Hematology and Clinical Oncology 'L. and A. Seràgnoli', S.Orsola-Malpighi Hospital, Bologna, Italy
| | - A Palmisano
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy
| | - C Buzio
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy
| | - L Bignardi
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy
| | - U Maggiore
- Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy
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