Parkinsonism and Related Disorders 21 (2015) 160e161

Contents lists available at ScienceDirect

Parkinsonism and Related Disorders journal homepage: www.elsevier.com/locate/parkreldis

Correspondence

Opsoclonus-myoclonus-ataxia syndrome associated with dengue virus infection Keywords: Dengue Opsoclonus Myoclonus Ataxia

Table 1 Reported associations with the opsoclonus-myoclonus-ataxia syndrome (OMAS). Para-infectious association

We thank the Editor for the opportunity to respond. The fact that opsoclonus-myoclonus-ataxia syndrome (OMAS) can be due to a wide variety of infections is well known, and in pediatric patients neuroblastoma is the “classic textbook” cause of this condition [1,2]. In our brief report [3], however, we took the approach of focusing on the neurological complications of dengue virus infection, and in particular OMAS. Although Wiwanitkit suggests that our cases could have viral hepatitis or “neurological tumour”, these possibilities are unlikely. Liver function tests were abnormal in Patient 1, but this is not uncommon and is entirely consistent with dengue infection [4]; serological tests for hepatitis A, B and C were negative. Liver function tests were normal in Patient 2. The normal imaging (of the brain, chest and abdomen), normal 24-h urinary vanillylmandelic acid (VMA) (Patient 2), and most importantly the marked and sustained clinical improvement (which occurred spontaneously in Patient 1, and in conjunction with short-term corticosteroid treatment in Patient 2) would also argue against a paraneoplastic phenomenon (both patients remain well as of the writing of this Letter, 11 and 18 months, respectively, after illness onset) [1,5]. We have conducted a literature review and compiled a comprehensive list of infections, tumors and other conditions reported to be associated with OMAS (Table 1; please see Supplementary Materials for a more complete list of references). More extensive investigations should therefore be guided by the patient's clinical picture. In regard to this, it should be borne in mind that paraneoplastic antibody testing is often negative in patients with paraneoplastic OMAS (86% in one series) [5]. As mentioned, the presentation of our patients (acute onset; typical symptoms of dengue including fever, headache, arthralgia, myalgia, generalized petechiae, and shock; and accompanying thrombocytopenia and leukopenia), occurring in locations highly endemic for dengue [6], was highly suggestive of dengue infection and the investigations that were performed to confirm this (positive dengue non-structural protein 1 [NS1] antigen test and dengue IgG antibody seroconversion) are also highly specific for this infection [4,7]. Thus, our report provides good support for the association between dengue and OMAS. http://dx.doi.org/10.1016/j.parkreldis.2014.11.009 1353-8020/© 2014 Elsevier Ltd. All rights reserved.

Viruses Human immunodeficiency virus [1e4] Herpesviruses, including EpsteineBarr virus [1e4], cytomegalovirus [2,4,5], varicella zoster virus [3,4], human herpesvirus 6 [4] Influenza A virus [4] Rotavirus [5] Hepatitis C virus [4,5] Enteroviruses, including coxsackievirus B3 [1e4,6] Arboviruses, including St Louis encephalitis [1e3] and West Nile virus [2,4] Mumps virus [1,4] Bacteria Streptococcus pyogenes [1,2,4] Mycoplasma pneumoniae [1,4,5] Chlamydia psittaci [2,4] Salmonella species [2,4,5] Rickettsia species [2,4] Borrelia burgdorferi [1,2,4] Mycobacterium tuberculosis [2] Tropical infections Dengue virus [7] Malaria (Plasmodium falciparum) [8] Paraneoplastic association Neuroblastoma [1e3] Ganglioneuroblastoma [1,3] Ganglioneuroma [1,3] Small cell lung carcinoma [1,2,3,9] Non-small cell lung carcinoma [2,3,9] Breast adenocarcinoma [1,2,3,9] Medullary thyroid carcinoma [1,2,9] Thymic carcinoma [9] Ovarian carcinoma [2] Ovarian teratoma [2] Cervical carcinoma in situ [2]

Paraneoplastic association (cont'd) Gastric adenocarcinoma [2,9] Esophageal carcinoma [10] Pancreatic carcinoma [1,9] Gall bladder carcinoma [9] Hepatoblastoma [11] Renal cell carcinoma [1,2,9] Bladder carcinoma [2,3] Malignant melanoma [1,2,9] Malignant fibrous histiocytoma [1] Neurofibrosarcoma [9] Chondrosarcoma [9] Non-Hodgkin lymphoma [2] Hodgkin lymphoma [9] Nonparaneoplastic, nonparainfectious, autoimmune association Anti-glutamic acid decarboxylase (GAD) antibody [2] Anti-glutamate receptor antibody [12] Anti-N-methyl-D-aspartate receptor (NMDAR) antibody [2,13] Anti-gliadin/anti-endomysial antibody/celiac disease [1,13] Anti-GQ1b antibody [13] Anti-GABAB receptor antibody [14] Others Pregnancy [2] Hyperosmolar coma [1e3] Posterior reversible encephalopathy syndrome (PRES) [15] Allogeneic hematopoietic stem cell transplantation [1] Cocaine [1,2] Vaccination for measles, mumps and rubella [4,16], human papilloma virus [16] Primary biliary cirrhosis [17] Vanishing white matter disease [18] Multiple carboxylase deficiency [3]

Correspondence / Parkinsonism and Related Disorders 21 (2015) 160e161

Appendix A. Supplementary data Supplementary data related to this article can be found at http:// dx.doi.org/10.1016/j.parkreldis.2014.11.009.

161

Ai Huey Tan Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, University of Malaya, Kuala Lumpur, Malaysia Kyaw Linn Pediatric Neurology Unit, Yangon Children's Hospital, Yangon, Myanmar

References [1] Gorman MP. Update on diagnosis, treatment, and prognosis in opsoclonusmyoclonus-ataxia syndrome. Curr Opin Pediatr 2010;22:745e50. [2] Klaas JP, Ahlskog JE, Pittock SJ, Matsumoto JY, Aksamit AJ, Bartleson JD, et al. Adult-onset opsoclonus-myoclonus syndrome. Arch Neurol 2012;69: 1598e607. [3] Tan AH, Linn K, Ramli NM, Hlaing CS, Aye AM, Sam IC, et al. Opsoclonus-myoclonus-ataxia syndrome associated with dengue virus infection. Parkinsonism Relat Disord 2014;20:1309e10. [4] Simmons CP, Farrar JJ, Chau NVV, Dengue Wills B. N Engl J Med 2012;366: 1423e32. [5] Bataller L, Graus F, Saiz A, Vilchez JJ for the Spanish Opsoclonus-Myoclonus Study. Clinical outcome in adult onset idiopathic or paraneoplastic opsoclonus-myoclonus. Brain 2001;124:437e43. ndez-G [6] Lam SK, Burke D, Gubler D, Me alvan J, Thomas L. Call for a world dengue day. Lancet 2012;379:411e2. [7] Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, et al. Dengue: a continuing global threat. Nat Rev Microbiol 2010;8(12 Suppl.): S7e16.

I-Ching Sam Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia Chong Tin Tan, Shen-Yang Lim* Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, University of Malaya, Kuala Lumpur, Malaysia *

Corresponding author. Neurology Laboratory, Level 6, Menara Selatan (South Block), University of Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia. Tel.: þ60 16 3518009; fax: þ60 03 79494613. E-mail address: [email protected] (S.-Y. Lim). 4 November 2014

Opsoclonus-myoclonus-ataxia syndrome associated with dengue virus infection.

Opsoclonus-myoclonus-ataxia syndrome associated with dengue virus infection. - PDF Download Free
171KB Sizes 0 Downloads 9 Views