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首页> 外文期刊>Journal of neurology >Monophasic demyelinat-ing disease of the central nervous system associated with Hepatitis A infection
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Monophasic demyelinat-ing disease of the central nervous system associated with Hepatitis A infection

机译：与甲型肝炎感染相关的中枢神经系统单相脱髓鞘疾病

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Sirs: Acute disseminated encephalomyelitis (ADEM) is an uncommon, acute demyelinating disorder of the central nervous system (CNS), usually monophasic and occurring after infections or vaccinations . Although a number of infectious agents seem to have a definite close implication in the pathogenesis of ADEM, isolated cases associated with hepatitis A virus (HAV) infection have been reported in children [1,8,11,12].A 29-year-old man with no history of neurological disease developed fever, headache, gait difficulty and urinary retention. Blood examinations revealed a high level of hepatic transaminases (1555 IU/L ALT, 540 IU/L AST) and a high titre of HAV IgM antibodies. In the following days he showed severe gait ataxia, bilateral pyramidal signs of the lower extremities, hypoesthesia with a sensory level at T10. Quantitative analysis of cerebrospinal fluid (CSF) was normal. Immuno-fixation with anti-IgG demonstrated the same band in the cathodic region of gamma-globulins both in serum and in CSF.
机译：主席先生：急性播散性脑脊髓炎（ADEM）是一种罕见的中枢神经系统（CNS）急性脱髓鞘疾病，通常是单相的，在感染或接种疫苗后发生。尽管许多传染病似乎与ADEM的发病机理有着密切的关系，但已报道儿童中与甲型肝炎病毒（HAV）感染相关的孤立病例[1,8,11,12]。29岁没有神经系统疾病病史的老人发烧，头痛，步态困难和尿retention留。血液检查发现肝转氨酶水平高（1555 IU / L ALT，540 IU / L AST）和高滴度的HAV IgM抗体。在接下来的几天中，他表现出严重的步态共济失调，下肢的双侧锥体束征，感觉不足，并在T10达到感觉水平。脑脊液（CSF）定量分析正常。用抗IgG进行的免疫固定在血清和CSF中的γ球蛋白的阴极区域显示出相同的条带。

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