scholarly journals Differential Diagnosis of Autoimmune Encephalitis from Infectious Lymphocytic Encephalitis by Analysing the Lymphocyte Subsets of Cerebrospinal Fluid

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Qiao-quan Zhang ◽  
Yan-fang Zhang ◽  
Nian Yu ◽  
Xing-jian Lin ◽  
Qing Di
Keyword(s):  
Cerebrospinal Fluid ◽  
B Lymphocytes ◽  
Lymphocyte Subsets ◽  
Developmental Stages ◽  
Autoimmune Encephalitis ◽  
Herpes Simplex Virus Encephalitis ◽  
Pathophysiological Mechanism ◽  
Diagnostic Values ◽  
Simplex Virus ◽  
Cd Markers

This study is aimed at investigating the lymphocyte subsets of cerebrospinal fluid (CSF) to provide possible differential diagnostic values and better understand the pathophysiological mechanism underlying autoimmune encephalitis (AE) and infectious lymphocytic encephalitis. A series of CD markers, including CD3/4/8/20 representing different types and developmental stages of lymphocytes, were used to count the corresponding subpopulations of CSF from clinical and laboratory confirmed cases of anti-N-methyl-D-aspartate receptor AE (NMDAR-AE), herpes simplex virus encephalitis (HSVE), and tuberculous meningitis (TBM). The percentages of lymphocytes observed and the CD4 : CD8 ratios were compared between the three groups. There were no significant differences of the percentage of total lymphocytes, CD3 cells, and CD4 cells of CSF among each group. However, there were strongly statistical differences of the CD4 : CD8 ratio in CSF of each group with 0.6 : 1 in NMDAR-AE, 0.9 : 1 in HSVE, and 3.2 : 1 in TBM. The percentage of CD20 B lymphocytes in NMDAR-AE was statistically higher than that of other groups. The distinct percentages of lymphocyte subpopulations of CSF appeared to be characteristic and could potentially serve as diagnostic indicators. Further verification and research will be necessary to clarify the significance and nature of CD4 : CD8 ratios and B lymphocytes in CSF between AE and the infectious lymphocytic encephalitis.

Quantitation of herpes simplex virus type 1 DNA in cells of cerebrospinal fluid of patients with herpes simplex virus encephalitis

Neurology ◽  
1997 ◽  
Vol 48 (5) ◽  
pp. 1341-1346 ◽  
Author(s):  
B. Wildemann ◽  
K. Ehrhart ◽  
B. Storch-Hagenlocher ◽  
U. Meyding-LamadB ◽  
S. Steinvorth ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Virus Type ◽  
Herpes Simplex Virus Type ◽  
Herpes Simplex Virus Encephalitis ◽  
Virus Encephalitis ◽  
Simplex Virus ◽  
In Cells

Absence of Pleocytosis in Cerebrospinal Fluid does not Exclude Herpes Simplex Virus Encephalitis in Elderly Adults

2015 ◽  
Vol 63 (6) ◽  
pp. 1278-1279 ◽  
Author(s):  
Benjamin Hebant ◽  
Nicolas Miret ◽  
Jean Paul Bouwyn ◽  
Elodie Delafosse ◽  
Romain Lefaucheur
Keyword(s):  
Cerebrospinal Fluid ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Herpes Simplex Virus Encephalitis ◽  
Elderly Adults ◽  
Virus Encephalitis ◽  
Simplex Virus

scholarly journals Antibody-Mediated Autoimmune Diseases of the CNS: Challenges and Approaches to Diagnosis and Management

2021 ◽  
Vol 12 ◽  
Author(s):  
Elia Sechi ◽  
Eoin P. Flanagan
Keyword(s):  
Checkpoint Inhibitors ◽  
Autoimmune Encephalitis ◽  
Herpes Simplex Virus Encephalitis ◽  
Cns Disorders ◽  
Neurologic Disorders ◽  
Cns Autoimmunity ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Simplex Virus ◽  
Clinical Mri

Antibody-mediated disorders of the central nervous system (CNS) are increasingly recognized as neurologic disorders that can be severe and even life-threatening but with the potential for reversibility with appropriate treatment. The expanding spectrum of newly identified autoantibodies targeting glial or neuronal (neural) antigens and associated clinical syndromes (ranging from autoimmune encephalitis to CNS demyelination) has increased diagnostic precision, and allowed critical reinterpretation of non-specific neurological syndromes historically associated with systemic disorders (e.g., Hashimoto encephalopathy). The intracellular vs. cell-surface or synaptic location of the different neural autoantibody targets often helps to predict the clinical characteristics, potential cancer association, and treatment response of the associated syndromes. In particular, autoantibodies targeting intracellular antigens (traditionally termed onconeural autoantibodies) are often associated with cancers, rarely respond well to immunosuppression and have a poor outcome, although exceptions exist. Detection of neural autoantibodies with accurate laboratory assays in patients with compatible clinical-MRI phenotypes allows a definite diagnosis of antibody-mediated CNS disorders, with important therapeutic and prognostic implications. Antibody-mediated CNS disorders are rare, and reliable autoantibody identification is highly dependent on the technique used for detection and pre-test probability. As a consequence, indiscriminate neural autoantibody testing among patients with more common neurologic disorders (e.g., epilepsy, dementia) will necessarily increase the risk of false positivity, so that recognition of high-risk clinical-MRI phenotypes is crucial. A number of emerging clinical settings have recently been recognized to favor development of CNS autoimmunity. These include antibody-mediated CNS disorders following herpes simplex virus encephalitis or occurring in a post-transplant setting, and neurological autoimmunity triggered by TNFα inhibitors or immune checkpoint inhibitors for cancer treatment. Awareness of the range of clinical and radiological manifestations associated with different neural autoantibodies, and the specific settings where autoimmune CNS disorders may occur is crucial to allow rapid diagnosis and early initiation of treatment.

scholarly journals Anti-NMDAR Encephalitis Following Herpes Simplex Virus Encephalitis: 2 Cases From Portugal

2019 ◽  
Vol 10 (2) ◽  
pp. 133-138
Author(s):  
Ana Brás ◽  
Ana André ◽  
Laura Sá ◽  
João Carvalho ◽  
Anabela Matos ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Specific Treatment ◽  
Autoimmune Encephalitis ◽  
Herpes Simplex Virus Encephalitis ◽  
Virus Encephalitis ◽  
Nmdar Encephalitis ◽  
Initial Improvement ◽  
Simplex Virus

Herpes simplex virus encephalitis (HSVE) usually presents as a monophasic disease. Symptomatic HSVE relapsing with seizures, encephalopathy, or involuntary movements associated with anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis have been recently reported. We report 2 cases of adult post-HSVE anti-NMDAR encephalitis from Portugal. Two female patients aged 50 years and 30 years were diagnosed with herpes simplex virus type 2 and type 1 encephalitis, respectively. After the initial improvement with specific treatment and despite virologic negativization, both patients suffered clinical, electroencephalographic, and imaging deterioration. The autoimmune encephalitis hypothesis was confirmed with the demonstration of anti-NMDAR antibodies in both cerebrospinal fluid and serum. Both responded to human immunoglobulin and methylprednisolone, with progressive gain of autonomy along the follow-up period. Thymectomy for thymic hyperplasia diagnosed during follow-up was performed in 1 patient. Although being rare, post-HSVE anti-NMDAR encephalitis should be considered in all cases of symptomatic recrudescence after HSVE, since adequate immune-modulating treatment improves the outcome. The role of thyme hyperplasia in autoimmune encephalitis pathogenesis needs better understanding.

Epstein–Barr virus DNA in cerebrospinal fluid from an immunocompetent man with herpes simplex virus encephalitis

1998 ◽  
Vol 4 (4) ◽  
pp. 461-464 ◽  
Author(s):  
Marinella Portolani ◽  
Anna Maria Teresa Sabbatini ◽  
Marisa Meacci ◽  
Paola Pietrosemoli ◽  
Claudio Cermelli ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Epstein Barr Virus ◽  
Herpes Simplex Virus Encephalitis ◽  
Virus Encephalitis ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus
Sign in / Sign up

Export Citation Format

Share Document