Zika virus found in brain tissue of a multiple sclerosis patient undergoing an acute disseminated encephalomyelitis-like episode. (March 2019)

• Record Type: Journal Article
• Authors: Alves-Leon, Soniza Vieira; Lima, Monique da Rocha; Nunes, Priscila Conrado Guerra; Chimelli, Leila Maria Cardão; Rabelo, Kíssila; Nogueira, Rita Maria Ribeiro; de Bruycker-Nogueira, Fernanda; de Azeredo, Elzinandes Leal; Bahia, Paulo Roberto; Rueda Lopes, Fernanda Cristina; Marcondes de Souza, Jorge P Barreto; Fontes-Dantas, Fabrícia Lima; Paes, Marciano Viana; Lemos, Elba RS; Santos, Flavia Barreto
• Is Part Of: Multiple sclerosis. Volume 25:Number 3(2019)
• Page Start: 427
• Page End: 430
• Publication Date: 2019-03
• Subjects: Multiple sclerosis -- Zika virus -- acute disseminated encephalomyelitis -- differential diagnosis -- immunotherapy; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458518781992
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: A range of different neurological manifestations has been reported in fetuses and adults after Zika virus (ZIKV) infection. Objective: We describe a detection of the ZIKV in the brain tissue from a multiple sclerosis (MS) patient with acute disseminated encephalomyelitis (ADEM)-like event in Rio de Janeiro, Brazil. Methods: Biological samples collected during the hospitalization were tested by serology and molecular diagnostic for various infectious agents. Histopathological analysis was performed using the anti-flavivirus group 4G2 monoclonal antibody, anti-ZIKV non-structural 1 (NS1) monoclonal antibody, and anti-CD4, CD8, and CD11b antibodies. Results: Anti-ZIKV IgM and IgG antibodies were positive in the serum and urine. A brain biopsy showed ZIKV protein in brain cells and T CD8 infiltration in brain tissue. Conclusion: Our data describe the coexistence of a recent central nervous system (CNS) ZIKV infection accompanied by a severe ADEM-like syndrome outcome in a patient with clinical history of MS. A de novo immune response concomitant with ZIKV infection might be involved in the mechanism of the ADEM-like syndrome and response to immunotherapy. The present report reinforces the importance of providing the differential diagnosis of acute episodes of MS exacerbation in an environment prone to ZIKV expression.