Childhood chronic inflammatory demyelinating polyneuropathy secondary to reactivation of Epstein-Barr virus

Article type: Research Article

Authors: Chieng, Siik Kwong | Hussain, Nahin | Gosalakkal, Jayaprakash Ayillath

Affiliations: Department of Pediatric Neurology, Leicester Royal Infirmary, University Hospital of Leicester, Leicester, UK

Note: [] Correspondence: Siik Kwong Chieng, MRCP-CH, 41 Hawthorn Court-Room 1, Walnut St., Leicester LE 2 7GP, UK. Tel.: +44 1162585564; Fax: +44 1162587637; E-mail: [email protected]

Abstract: A case of childhood chronic inflammatory demyelinating polyneuropathy (CIDP) due to Epstein-Barr virus (EBV) infection is reported. A 15-year-old male presented with CIDP, which initially mimicked Guillain-Barré syndrome. He subsequently developed major relapses at four and five months after initial presentation. He recovered six weeks after the last relapse. Serological studies showed positive Epstein-Barr nuclear antigen IgG and negative EBV viral capsid antigen IgM. However, EBV deoxyribonucleic acid was detected by polymerase chain reaction from cerebrospinal fluid, measuring up to 1000 copies/mL. His CIDP, which ran a relapsing course, could be explained by reactivation of latent EBV, triggered by other viral illness. Given patient's full recovery, the mechanism of injury is likely due to EBV-associated immune-mediated process, rather than from a direct viral infiltration of the peripheral nerve. This is the first report of a CIDP with documented EBV infection in cerebrospinal fluid.

Keywords: Chronic inflammatory demyelinating polyneuropathy, Guillain-Barré syndrome, Epstein-Barr virus

Journal: Journal of Pediatric Neurology, vol. 5, no. 2, pp. 153-156, 2007