Cargando…
CSF herpes virus and autoantibody profiles in the evaluation of encephalitis
OBJECTIVE: To report the frequency of coexisting herpes viruses (herpes simplex virus 1 [HSV-1] or HSV-2, varicella zoster virus, Epstein-Barr virus [EBV], cytomegalovirus, or human herpes virus 6 [HHV-6]) and autoantibodies in patients with encephalitis (herpes or autoimmune) in clinical laboratory...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897981/ https://www.ncbi.nlm.nih.gov/pubmed/27308306 http://dx.doi.org/10.1212/NXI.0000000000000245 |
_version_ | 1782436273808474112 |
---|---|
author | Linnoila, Jenny J. Binnicker, Matthew J. Majed, Masoud Klein, Christopher J. McKeon, Andrew |
author_facet | Linnoila, Jenny J. Binnicker, Matthew J. Majed, Masoud Klein, Christopher J. McKeon, Andrew |
author_sort | Linnoila, Jenny J. |
collection | PubMed |
description | OBJECTIVE: To report the frequency of coexisting herpes viruses (herpes simplex virus 1 [HSV-1] or HSV-2, varicella zoster virus, Epstein-Barr virus [EBV], cytomegalovirus, or human herpes virus 6 [HHV-6]) and autoantibodies in patients with encephalitis (herpes or autoimmune) in clinical laboratory service. METHODS: Three groups were evaluated for herpes viruses and antibodies: group 1—patients whose CSF was positive for a herpes virus by real-time PCR over a period of 6 months; group 2—patients whose CSF was positive for an autoimmune encephalitis–associated antibody over 5 years (e.g., NMDA receptor [NMDA-R] antibody), and the same number of controls without autoimmune/infectious disease; and group 3—incidental autoimmune parainfectious encephalitis cases encountered over 1 year. RESULTS: In group 1, antibodies were detected in 27 of 100 herpes PCR-positive CSF specimens (CSFs), either unclassified neural or nonneural in all but one patient with NMDA-R antibody detected after EBV infection. Antibodies were also detected in 3 of 7 CSFs submitted for repeat PCR testing (unclassified, 2; AMPA receptor, 1). In group 2, herpes viruses were detected in 1 of 77 controls (HHV-6) and 4 of 77 patients with autoimmune encephalitis (EBV, 2; HHV-6, 2); autoantibodies targeted NMDA-R in 3/4 and GABA(B)-R in 1/4. In group 3, NMDA-R antibody was detected in 7 patients post–HSV-1 encephalitis. Of the remaining 3 patients, 2 had unclassified neural antibodies detected, and one had GABA(B)-R autoimmunity. Concomitant neoplasms were discovered in 2 patients each from groups 2 and 3. CONCLUSIONS: Autoantibodies and herpes virus DNA frequently coexist in encephalitic CSF. Some patients develop parainfectious autoimmunity following viral CNS infection (usually HSV-1 encephalitis). The significance of detecting herpes nucleic acids in others remains unclear. |
format | Online Article Text |
id | pubmed-4897981 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-48979812016-06-15 CSF herpes virus and autoantibody profiles in the evaluation of encephalitis Linnoila, Jenny J. Binnicker, Matthew J. Majed, Masoud Klein, Christopher J. McKeon, Andrew Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: To report the frequency of coexisting herpes viruses (herpes simplex virus 1 [HSV-1] or HSV-2, varicella zoster virus, Epstein-Barr virus [EBV], cytomegalovirus, or human herpes virus 6 [HHV-6]) and autoantibodies in patients with encephalitis (herpes or autoimmune) in clinical laboratory service. METHODS: Three groups were evaluated for herpes viruses and antibodies: group 1—patients whose CSF was positive for a herpes virus by real-time PCR over a period of 6 months; group 2—patients whose CSF was positive for an autoimmune encephalitis–associated antibody over 5 years (e.g., NMDA receptor [NMDA-R] antibody), and the same number of controls without autoimmune/infectious disease; and group 3—incidental autoimmune parainfectious encephalitis cases encountered over 1 year. RESULTS: In group 1, antibodies were detected in 27 of 100 herpes PCR-positive CSF specimens (CSFs), either unclassified neural or nonneural in all but one patient with NMDA-R antibody detected after EBV infection. Antibodies were also detected in 3 of 7 CSFs submitted for repeat PCR testing (unclassified, 2; AMPA receptor, 1). In group 2, herpes viruses were detected in 1 of 77 controls (HHV-6) and 4 of 77 patients with autoimmune encephalitis (EBV, 2; HHV-6, 2); autoantibodies targeted NMDA-R in 3/4 and GABA(B)-R in 1/4. In group 3, NMDA-R antibody was detected in 7 patients post–HSV-1 encephalitis. Of the remaining 3 patients, 2 had unclassified neural antibodies detected, and one had GABA(B)-R autoimmunity. Concomitant neoplasms were discovered in 2 patients each from groups 2 and 3. CONCLUSIONS: Autoantibodies and herpes virus DNA frequently coexist in encephalitic CSF. Some patients develop parainfectious autoimmunity following viral CNS infection (usually HSV-1 encephalitis). The significance of detecting herpes nucleic acids in others remains unclear. Lippincott Williams & Wilkins 2016-06-01 /pmc/articles/PMC4897981/ /pubmed/27308306 http://dx.doi.org/10.1212/NXI.0000000000000245 Text en © 2016 American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Article Linnoila, Jenny J. Binnicker, Matthew J. Majed, Masoud Klein, Christopher J. McKeon, Andrew CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title | CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title_full | CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title_fullStr | CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title_full_unstemmed | CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title_short | CSF herpes virus and autoantibody profiles in the evaluation of encephalitis |
title_sort | csf herpes virus and autoantibody profiles in the evaluation of encephalitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897981/ https://www.ncbi.nlm.nih.gov/pubmed/27308306 http://dx.doi.org/10.1212/NXI.0000000000000245 |
work_keys_str_mv | AT linnoilajennyj csfherpesvirusandautoantibodyprofilesintheevaluationofencephalitis AT binnickermatthewj csfherpesvirusandautoantibodyprofilesintheevaluationofencephalitis AT majedmasoud csfherpesvirusandautoantibodyprofilesintheevaluationofencephalitis AT kleinchristopherj csfherpesvirusandautoantibodyprofilesintheevaluationofencephalitis AT mckeonandrew csfherpesvirusandautoantibodyprofilesintheevaluationofencephalitis |