title: [A case of chronic active Epstein-Barr virus infection associated with recurrent cerebellar ataxia and skin eruptions].
abstract: A 62-year-old woman presented with subacute cerebellar ataxia, lymph node swelling and skin eruption. Laboratory tests revealed elevated titers of anti-VCA-IgG antibody and anti-EADR-IgG antibody, with Epstein-Barr virus (EBV) DNA detected from the blood and CSF by PCR. Since these data were highlighted with the diagnosis of chronic active EBV infection (CAEBV) and her ataxia improved concomitantly with the remission of other infectious mononucleosis-like symptoms, we supposed her ataxia is associated with CAEBV. Five years later, at the age of 67, her ataxia relapsed concurrently with skin eruptions, whereas MRI demonstrated progression of cerebellar atrophy. After high-dose intravenous methylprednisolone treatment, the clinical symptoms resolved. Initial infection of EBV in childhood often causes autoimmune acute cerebellitis but cerebellar ataxia has rarely been described in CAEBV. Furthermore, immunohistochemical analysis revealed a reactivity of the patient's serum and CSF on rat cerebellum, suggesting an autoimmune pathomechanism for the ataxia.
authors.affiliation: Department of Neurology, Osaka University Hospital.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Araki
authors.forename: Tatsusada
authors.initials: T
authors.lastname: Okuno
authors.forename: Josephe Archie
authors.initials: JA
authors.lastname: Honorat
authors.forename: Makoto
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Masanori P
authors.initials: MP
authors.lastname: Takahashi
authors.forename: Masao
authors.initials: M
authors.lastname: Mizuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Mochizuki
mesh_terms: D000368:Aged; D002524:Cerebellar Ataxia / Q000209:etiology*; D002908:Chronic Disease; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012871:Skin Diseases / Q000209:etiology*