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Short communication| Volume 276, ISSUE 1-2, P184-186, January 15, 2009

Aquaporin-4 antibody positive longitudinally extensive transverse myelitis following varicella zoster infection

DOI:https://doi.org/10.1016/j.jns.2008.08.015
Aquaporin-4 antibody positive longitudinally extensive transverse myelitis following varicella zoster infection
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      Abstract

      Longitudinally extensive transverse myelitis (LETM) is a condition shown to confer high risk of conversion into neuromyelitis optica (NMO). Increasing evidence from immunological and histopathological studies suggests that LETM is an autoimmune disorder caused by pathogenic antibodies to aquaporin-4 (AQP4-Ab), the most abundant water channel in the CNS, at least in a subset of patients. However, cases of infectious or parainfectious NMO/LETM (mostly associated with herpes zoster) have been repeatedly reported in the previous literature, raising the question of aetiological diversity in NMO/LETM. Here we present a case of acute LETM in a 63-year-old patient occurring two weeks after reactivation of varicella zoster virus (VZV). Serological testing revealed antibodies to AQP4. Plasma exchange was paralleled by disappearance of AQP4-Ab and sustained clinical improvement. Our observations provide further evidence for a pathogenic role of AQP4-Ab in LETM and suggest that AQP4-Ab associated auto-immunity should be considered also in apparently infectious/parainfectious settings.

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      Article info

      Publication history

      Accepted: August 15, 2008
      Received in revised form: August 13, 2008
      Received: May 26, 2008

      Identification

      DOI: https://doi.org/10.1016/j.jns.2008.08.015

      Copyright

      © 2008 Elsevier B.V. Published by Elsevier Inc. All rights reserved.

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