Recurrent transverse myelitis following neurobrucellosis: Immunologic features and beneficial response to immunosuppression

Chitra Krishnan, Adam I. Kaplin, Jerome S. Graber, Jessica S. Darman, Douglas A. Kerr

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The authors report the clinical course and immune system response of a patient with disease-associated recurrent transverse myelitis (TM) following cerebral infection with Brucellosis melitensis. The patient suffered four recurrences of his TM (each at a distinct spinal cord level) over the course of 2 years following his initial presentation, which ultimately progressed to quadriplegia. He had progressively declining cerebrospinal fluid (CSF) brucella antibody titers, suggesting a postinfectious, rather than an infectious, etiology. The authors simultaneously examined the expression of multiple cytokines in the CSF of this patient using cytokine antibody arrays and found a marked elevation of interleukin (IL)-6, IL-8, and macrophage chemoattractant protein (MCP)-1 levels relative to controls. Quantitative enzyme-linked immunosorbent assay (ELISA) analysis of the CSF confirmed a 1700-fold elevation of IL-6 and more modest elevations of IL-8 and MCP-1. IL-6 levels returned to baseline following treatment of the patient with intravenous cyclophosphamide and plasma exchange and the patient experienced a significant and sustained recovery of function.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalJournal of NeuroVirology
Volume11
Issue number2
DOIs
StatePublished - Apr 2005
Externally publishedYes

Fingerprint

Transverse Myelitis
Immunosuppression
Cerebrospinal Fluid
Interleukin-6
Chemotactic Factors
Interleukin-8
Macrophages
Cytokines
Brucella
Quadriplegia
Plasma Exchange
Brucellosis
Antibodies
Recovery of Function
Cyclophosphamide
Immune System
Spinal Cord
Proteins
Enzyme-Linked Immunosorbent Assay
Recurrence

Keywords

  • Cytokine
  • IL-6
  • Immunosuppression
  • Neurobrucella
  • Plasma exchange
  • Recurrent
  • Transverse myelitis

ASJC Scopus subject areas

  • Virology
  • Clinical Neurology

Cite this

Recurrent transverse myelitis following neurobrucellosis : Immunologic features and beneficial response to immunosuppression. / Krishnan, Chitra; Kaplin, Adam I.; Graber, Jerome S.; Darman, Jessica S.; Kerr, Douglas A.

In: Journal of NeuroVirology, Vol. 11, No. 2, 04.2005, p. 225-231.

Research output: Contribution to journalArticle

Krishnan, Chitra ; Kaplin, Adam I. ; Graber, Jerome S. ; Darman, Jessica S. ; Kerr, Douglas A. / Recurrent transverse myelitis following neurobrucellosis : Immunologic features and beneficial response to immunosuppression. In: Journal of NeuroVirology. 2005 ; Vol. 11, No. 2. pp. 225-231.
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