A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody
Abstract Background We reported on a case involving an older patient with HSV-1 encephalitis who simultaneously experienced the onset of peripheral nerve symptoms associated with the presence of anti-GM3 immunoglobulin G (IgG). Case presentation A 77-year-old male was admitted to hospital with high...
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| Format: | Article |
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BMC
2023-05-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-023-03238-y |
| _version_ | 1797822813437952000 |
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| author | Hongji Lu Yingdi Liao Changlin Zhang Wanxin Wen Yaming Du Min Zhao Lixin Wang |
| author_facet | Hongji Lu Yingdi Liao Changlin Zhang Wanxin Wen Yaming Du Min Zhao Lixin Wang |
| author_sort | Hongji Lu |
| collection | DOAJ |
| description | Abstract Background We reported on a case involving an older patient with HSV-1 encephalitis who simultaneously experienced the onset of peripheral nerve symptoms associated with the presence of anti-GM3 immunoglobulin G (IgG). Case presentation A 77-year-old male was admitted to hospital with high fever, weakness of both lower limbs, and an unstable gait. A CSF test revealed a strikingly increased protein level (1,002 mg/L, normative values: 150-450 mg/L) and MRI revealed hyper-signal lesions in the right temporal lobe, right hippocampus, right insula, and right cingulate gyrus. The CSF was positive for HSV PCR (HSV-1,17870). In addition, the serum samples were positive for CASPR2 antibodies (antibody titer: 1/10) and anti-GM3 immunoglobulin G (IgG) (+). The patient was diagnosed with HSV-1-induced peripheral nerve symptoms that were associated with encephalitis and the presence of anti-GM3 IgG and anti-CASPR2 antibodies. The patient had received included intravenous immunoglobulin, intravenous acyclovir, and corticosteroids therapy. At the one-year follow-up examination, he had regained the necessary skills associated with daily life. Conclusions Herpes simplex virus infection often induces encephalitis, and reaction to the virus may trigger an autoimmune response. Early diagnosis and treatment can avoid the progression of the disease to include autoimmune encephalitis. |
| first_indexed | 2024-03-13T10:14:47Z |
| format | Article |
| id | doaj.art-8180b90e5dd44332afba25437a727f73 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-13T10:14:47Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-8180b90e5dd44332afba25437a727f732023-05-21T11:19:32ZengBMCBMC Neurology1471-23772023-05-012311510.1186/s12883-023-03238-yA case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibodyHongji Lu0Yingdi Liao1Changlin Zhang2Wanxin Wen3Yaming Du4Min Zhao5Lixin Wang6The Neurological Intensive Care Unit of Guangdong Provincial Hospital of Chinese MedicineThe Rehabilitation Department, Kunming Municipal Hospital of Traditional Chinese MedicineThe Second Clinical School, Guangzhou University of Chinese MedicineThe Neurological Intensive Care Unit of Guangdong Provincial Hospital of Chinese MedicineThe Second Clinical School, Guangzhou University of Chinese MedicineThe Second Clinical School, Guangzhou University of Chinese MedicineThe Neurological Intensive Care Unit of Guangdong Provincial Hospital of Chinese MedicineAbstract Background We reported on a case involving an older patient with HSV-1 encephalitis who simultaneously experienced the onset of peripheral nerve symptoms associated with the presence of anti-GM3 immunoglobulin G (IgG). Case presentation A 77-year-old male was admitted to hospital with high fever, weakness of both lower limbs, and an unstable gait. A CSF test revealed a strikingly increased protein level (1,002 mg/L, normative values: 150-450 mg/L) and MRI revealed hyper-signal lesions in the right temporal lobe, right hippocampus, right insula, and right cingulate gyrus. The CSF was positive for HSV PCR (HSV-1,17870). In addition, the serum samples were positive for CASPR2 antibodies (antibody titer: 1/10) and anti-GM3 immunoglobulin G (IgG) (+). The patient was diagnosed with HSV-1-induced peripheral nerve symptoms that were associated with encephalitis and the presence of anti-GM3 IgG and anti-CASPR2 antibodies. The patient had received included intravenous immunoglobulin, intravenous acyclovir, and corticosteroids therapy. At the one-year follow-up examination, he had regained the necessary skills associated with daily life. Conclusions Herpes simplex virus infection often induces encephalitis, and reaction to the virus may trigger an autoimmune response. Early diagnosis and treatment can avoid the progression of the disease to include autoimmune encephalitis.https://doi.org/10.1186/s12883-023-03238-yHerpes simplex virusPeripheral neuropathyEncephalitisGM3 antibodyCASPR2 antibody |
| spellingShingle | Hongji Lu Yingdi Liao Changlin Zhang Wanxin Wen Yaming Du Min Zhao Lixin Wang A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody BMC Neurology Herpes simplex virus Peripheral neuropathy Encephalitis GM3 antibody CASPR2 antibody |
| title | A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody |
| title_full | A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody |
| title_fullStr | A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody |
| title_full_unstemmed | A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody |
| title_short | A case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive GM3 and CASPR2 antibody |
| title_sort | case of herpes simplex virus induced peripheral neuropathy and encephalitis with positive gm3 and caspr2 antibody |
| topic | Herpes simplex virus Peripheral neuropathy Encephalitis GM3 antibody CASPR2 antibody |
| url | https://doi.org/10.1186/s12883-023-03238-y |
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