https://scholars.lib.ntu.edu.tw/handle/123456789/522979
標題: | Chronic hepatitis B infection presenting with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A case report | 作者: | Weng C.-F. DING-CHENG CHAN YA-FANG CHEN Liu F.-C. HORNG-HUEI LIOU |
公開日期: | 2015 | 出版社: | BioMed Central | 卷: | 9 | 期: | 1 | 起(迄)頁: | 266 | 來源出版物: | Journal of Medical Case Reports | 摘要: | Introduction: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids is a brainstem disorder characterized by perivascular pathologic reaction with lymphocyte infiltration and leading to diplopia, facial palsy, dysarthria, and gait ataxia. It was thought to be an autoimmune disorder without distinct pathogenesis. Chronic hepatitis B virus infection has been proposed in correlation with autoimmune diseases, including central nervous system demyelinating disease. Patients with chronic hepatitis B infection may develop the syndrome of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. Case presentation: A 34-year-old Taiwanese man who had been a hepatitis B virus carrier for a decade presented to our emergency room. He had influenza symptoms and progressive symptoms of left hemifacial numbness, double vision, and an unsteady gait of 2 days' duration. Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids was diagnosed, with increased hepatitis B viral load at the same time. He had no past history of similar neurologic deficits, and his liver function tests had been within normal limits before this episode. After corticosteroid and entecavir treatments, his neurological deficits and neuroimaging anomalies improved and his serum hepatitis B virus DNA viral load normalized. Conclusions: Hepatitis B virus infection may induce central nervous system autoimmune reactions, including chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. In such cases, concomitant administration of corticosteroids and antiviral agent was helpful. We suggest further investigations in patients with regulatory T cell dysfunction, which may assist in clarifying a loss of immune tolerance in patients with such disorders. ? 2015 Weng et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84947281875&doi=10.1186%2fs13256-015-0750-1&partnerID=40&md5=0db8f582488901551b470e385d4cf739 https://scholars.lib.ntu.edu.tw/handle/123456789/522979 |
ISSN: | 1752-1947 | DOI: | 10.1186/s13256-015-0750-1 | SDG/關鍵字: | corticosteroid; entecavir; hepatitis B(e) antibody; prednisolone; virus DNA; acupuncture; adult; Article; ataxia; autoimmune disease; brain disease; case report; cerebrospinal fluid analysis; Chinese medicine; chronic hepatitis B; chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroid; dizziness; drug megadose; dysarthria; dysmetria; headache; Hepatitis B virus; human; male; nausea and vomiting; nuclear magnetic resonance imaging; pleocytosis; priority journal; stiff neck; chronic hepatitis B; complication; Demyelinating Diseases; encephalomyelitis; neuroimaging; pathophysiology; pons; Adrenal Cortex Hormones; Adult; Demyelinating Diseases; Encephalomyelitis; Hepatitis B, Chronic; Humans; Magnetic Resonance Imaging; Male; Neuroimaging; Pons |
顯示於: | 醫學系 |
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