Title of article :
A Case of Hypogammaglobulinemia with Enteroviral Meningoencephalitis, Associated with Increased Adenosine Deaminase in Cerebrospinal Fluid
Author/Authors :
Alborzi, Abdolvahab Department of Microbiology - Professor Alborzi Clinical Microbiology Research Center - Shiraz University of Medical Sciences, Shiraz , Hosseini-nasab, Ali Kerman University of Medical Sciences, Kerman , Zeyaeian, Mazyar Department of Microbiology - Professor Alborzi Clinical Microbiology Research Center - Shiraz University of Medical Sciences, Shiraz , Sanaei, Anahita Department of Microbiology - Professor Alborzi Clinical Microbiology Research Center - Shiraz University of Medical Sciences, Shiraz , Kashef, Sara Department of Immunology-Allergy - Allergy Research Center - Shiraz University of Medical Sciences, Shiraz
Abstract :
We describe the development of enterovirus meningoencephalitis associated with
increased adenosine deaminase in cerebrospinal fluid of a 12-year-old boy, a known case of
hypogamaglobulinemia despite monthly replacement of IVIg.
The patient was referred to our center with fever, headache and vomiting for 10 days.
CSF analysis was compatible with aseptic meningoencephalitis but high CSF protein
(>200mg/dl) and high level of adenosine deaminase in CSF (30IU/L) were against the
diagnosis of simple viral meningoencephalitis. Nested PCR of CSF for entrovirus was
positive. Treatment with daily high-dose IVIg was commenced, with significant clinical
improvement.
For patients with increased ADA and lymphocytic pleocytosis in CSF, differential
diagnoses should include enteroviral meningitis. Antibodies, although crucial, cannot on their
own prevent enteroviral infection in some hypogamaglbulinemic patients.
Keywords :
Adenosine deaminase , Cerebrospinal fluid , Hypogamaglobulinemia , Enteroviral meningoencephalitis
Journal title :
Astroparticle Physics
