Multiphasic acute disseminated encephalomyelitis associated with atypical rubella virus infection.
We report the first case of an occurrence of multiphasic acute disseminated encephalomyelitis (ADEM) associated with atypical rubella virus infection with no rash and long-term increased titers of serum anti-rubella IgM in a 17-year-old male who had no history of rubella vaccination. He suffered from at least six clinical exacerbations with disseminated hyperintense lesions on FLAIR MR images during the course of 18 months. Repeated methylprednisolone pulse therapy and intravenous immunoglobulin therapy resolved the exacerbations. In patients with multiphasic ADEM of unknown etiology, clinicians should also consider the possibility of preceding infection with rubella virus.
Kyushu University, Japan.
Koji
K
Shinoda
Japanese Red Cross Hiroshima College of Nursing, Japan.
Hideaki
H
Asahara
Kyushu University, Japan.
Taira
T
Uehara
Kushiro Kita Hospital, Japan.
Katsue
K
Miyoshi
Kyushu University, Japan.
Satoshi O
SO
Suzuki
Kyushu University, Japan.
Toru
T
Iwaki
Kyushu University, Japan kira@neuro.med.kyushu-u.ac.jp.
Jun-ichi
J
Kira
D000293:Adolescent; D004673:Encephalomyelitis, Acute Disseminated / Q000209:etiology*; D006801:Humans; D008297:Male; D012409:Rubella / Q000150:complications*; D012412:Rubella virus / Q000472:pathogenicity*
MRI; Multiphasic acute disseminated encephalomyelitis; brain biopsy; rubella