RESUMO
We report here one case of Zika virus (ZIKV) infection associated with auto-immunity directed against the central nervous system in a Brazilian woman who developed acute transverse myelitis 9 days after recovery from an acute episode of fever with generalized erythema. Imaging of the spinal cord showed an elongated area on the T1-T10 level with gadolinium uptake. The diagnostic of the ZIKV infection was confirmed by cerebrospinal fluid and serum analysis. This patient had serum positivity for autoantibodies against myelin oligodendrocyte glycoprotein (MOG), a specific antibody against the myelin sheath. We propose that a direct central nervous system infection by ZIKV could lead to a specific auto-immunity against MOG protein.
Assuntos
Autoanticorpos/biossíntese , Eritema/imunologia , Mielite Transversa/imunologia , Medula Espinal/imunologia , Infecção por Zika virus/imunologia , Zika virus/patogenicidade , Doença Aguda , Adulto , Brasil , Meios de Contraste/administração & dosagem , Eritema/complicações , Eritema/diagnóstico por imagem , Eritema/virologia , Feminino , Gadolínio/administração & dosagem , Humanos , Imageamento por Ressonância Magnética , Bainha de Mielina/imunologia , Bainha de Mielina/patologia , Bainha de Mielina/virologia , Glicoproteína Mielina-Oligodendrócito/antagonistas & inibidores , Glicoproteína Mielina-Oligodendrócito/imunologia , Mielite Transversa/diagnóstico por imagem , Mielite Transversa/etiologia , Mielite Transversa/virologia , Medula Espinal/diagnóstico por imagem , Medula Espinal/virologia , Zika virus/fisiologia , Infecção por Zika virus/complicações , Infecção por Zika virus/diagnóstico por imagem , Infecção por Zika virus/virologiaRESUMO
OBJECTIVE: Antibodies against Myelin Oligodendrocyte glycoprotein (MOG-Ab) have been investigated as potential biological marker for neuromyelitis optica (NMO) and high-risk syndromes (HR) negative for AQP4-Ab in populations with different ethnic background. We tested AQP4 and MOG antibodies in a Brazilian population with high African ethnic background. METHOD: The study population was composed of adult patients from Rio de Janeiro with inflammatory demyelinating diseases (new and old cases). Blood samples were sent blindly to test the AQP4 and MOG antibodies by CBA. The frequency of positive MOG-Ab was estimated in the NMOHR and the NMO spectrum disorders (NMOSD). A systematic review with meta-analysis assessed the frequency of MOG-Ab in Caucasians and non-Caucasians. RESULTS: 200 adult patients (52% Afro-Brazilian) 115 of them with NMOHR were tested. MOG antibodies were found in 5/68 negative cases of AQP4-Ab negative (7%). The criteria for NMOSD were fulfilled by 70 patients with NMOHR and none of them was positive for MOG-Ab. A low prevalence of MOG antibodies and a predominant phenotype of bilateral Optic Neuritis were found in most non-Caucasian patients. CONCLUSION: The low frequency of MOG Ab in patients from Rio de Janeiro and in other non-Caucasian populations suggests a racial/ancestral influence.
