title: La crosse virus encephalitis preceding neurosarcoidosis diagnosed by brain biopsy.
abstract: Childhood neurosarcoidosis is rare, and its etiology is unknown. La Crosse virus is one of the most common causes of encephalitis in North America. We report the case of a 12-year-old boy who had La Crosse virus encephalitis and subsequently developed imaging and pathologic findings suggestive of neurosarcoidosis. He presented with acute onset of transient aphasia 4 months after an episode of encephalitis; serology results at the time of aphasia were positive for La Crosse virus. Brain MRI revealed diffuse subcortical nodular lesions. His serum angiotensin-converting enzyme level was elevated, and brain biopsy revealed noncaseating granuloma. It is interesting to note that he has had no recurrence of aphasia; repeat MRI showed significant improvement of nodular lesions without therapy. To our knowledge, this is the first case of La Crosse virus encephalitis associated with neurosarcoid findings.
authors.affiliation: Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd, Detroit, MI 48201-2119, USA. dkobayas@dmc.org
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kobayashi
authors.forename: Kelly
authors.initials: K
authors.lastname: Rouster-Stevens
authors.forename: Amy
authors.initials: A
authors.lastname: Harper
mesh_terms: D001706:Biopsy; D002493:Central Nervous System Diseases / Q000473:pathology; D002648:Child; D004670:Encephalitis, California / Q000473:pathology*; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D018062:La Crosse virus; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D012507:Sarcoidosis / Q000473:pathology; D014057:Tomography, X-Ray Computed