title: Charcot's arthropathy secondary to herpetic encephalitis sequelae: an unusual presentation.
abstract: Neuropathic arthropathy (Charcot's arthropathy) is a progressive articular disease associated with a reduced sensorial and protector proprioceptive reflex. Its etiology includes many different conditions such as syringomyelia, traumatic lesion causing medullary deformity, spina bifida, diabetic neuropathy, leprosy neuropathy, neurofibromatosis, amyloid neuropathy, alcohol, and repetitive injection of hydrocortisone into joints, among others. However, the relationship between Charcot's arthropathy and herpetic encephalitis has not yet been described. Herpes encephalitis causes acute and chronic diseases of the peripheral or central nervous system. It can manifest as subacute encephalitis, recurrent meningitis, or myelitis. It can also resemble psychiatric syndromes, diplopia, sensory changes in the face and limbs, personality changes, frontal dysexecutive syndrome, stiff neck, subclinical alterations of the vestibular function, intracranial hypertension, convulsion, hemiparesis, and generally includes motor components, among others. On the other hand, pure peripheral sensory disturbance has not been described. In this article, we report the clinical case of a patient with Charcot's arthropathy secondary to pure peripheral sensory polyneuropathy as a consequence of progressive herpetic encephalitis sequelae. In this article, the authors report the first case of Charcot's arthropathy secondary to herpetic encephalitis.
authors.affiliation: Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Samuel Katsuyuki
authors.initials: SK
authors.lastname: Shinjo
authors.forename: Jozélio Freire
authors.initials: JF
authors.lastname: de Carvalho
mesh_terms: D000344:Afferent Pathways / Q000276:immunology / Q000473:pathology / Q000821:virology; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology; D001177:Arthropathy, Neurogenic / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D018450:Disease Progression; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology; D020803:Encephalitis, Herpes Simplex / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000276:immunology* / Q000503:physiopathology / Q000821:virology*; D011859:Radiography; D011984:Sensory Receptor Cells / Q000276:immunology / Q000473:pathology / Q000821:virology