Subacute sclerosing panencephalitis in an infant: diagnostic role of viral genome analysis.
Subacute sclerosing panencephalitis (SSPE) is related to "defective" measles virus or vaccination, though an association with parainfluenza viruses has been reported. SSPE is characterized by a slow, erratic course and elevated cerebrospinal fluid measles titers. An immunocompetent, vaccinated infant, with onset of symptoms in parainfluenza virus season and a catastrophic course is described. Cerebrospinal fluid titers were negative, but postmortem brain had typical SSPE lesions. Patient brain-derived RNA, subjected to reverse transcription followed by polymerase chain reaction yielded polymerase chain reaction products with measles virus but not parainfluenza virus genes. The sequenced fragment revealed multiple mutations, typical for SSPE. SSPE can thus present in infants, with short latency and no cerebrospinal fluid antibodies. Viral genomic analysis may be diagnostic, permitting early therapy.
Department of Neurology, University of Southern California, Los Angeles.
T Z
TZ
Baram
I
I
Gonzalez-Gomez
Z D
ZD
Xie
D
D
Yao
F H
FH
Gilles
M D
MD
Nelson
H T
HT
Nguyen
J
J
Peters
D000956:Antigens, Viral / Q000134:cerebrospinal fluid; D001483:Base Sequence; D001921:Brain / Q000473:pathology; D005260:Female; D016679:Genome, Viral; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008459:Measles virus / Q000235:genetics* / Q000276:immunology; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D018108:Respirovirus / Q000235:genetics* / Q000276:immunology; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D014158:Transcription, Genetic; D014611:Vaccination
D000956:Antigens, Viral