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Clin Immunol. 2019 Oct;207:97-99. doi: 10.1016/j.clim.2019.07.007. Epub 2019 Aug 24.

West Nile Virus infection triggering autoimmune encephalitis: Pathophysiological and therapeutic implications.

Author information

1
Department of Pathophysiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
2
Department of Pathophysiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: halexo@med.uoa.gr.
3
3rd Department of Internal Medicine, Henry Dunant Hospital Center, Athens, Greece.
4
Department of Neurology, Henry Dunant Hospital Center, Athens, Greece.
5
Academy of Athens, Medical Sciences - Immunology, Athens, Greece.

Abstract

BACKGROUND:

A contributing factor in triggering autoimmune phenomena is pathogen infections. Here we describe a case that expands the spectrum of infection-associated autoimmune encephalitis and discuss plausible pathogenetic mechanisms.

DESIGN:

Case report and in silico analysis.

RESULTS:

A patient with West Nile Virus infection developed autoimmune encephalitis with positive anti-glycine receptor antibodies. Combination therapy with corticosteroids and intravenous immunoglobulin resulted in the resolution of encephalitis signs and symptoms. An in silico analysis unveiled certain sequence similarities between viral antigens and receptor sequence fragments suggesting a molecular mimicry autoimmunization process.

CONCLUSIONS:

Our case indicates that West Nile Virus infections can trigger autoimmune encephalitis. Our finding expands the spectrum of autoimmune conditions that can develop following an infection. Whether the autoimmunization process is due to molecular mimicry or due to the expansion of natural autoantibody clones merits further investigation.

KEYWORDS:

Autoimmunity; Molecular mimicry; Natural autoantibodies; Viral infection

PMID:
31454696
DOI:
10.1016/j.clim.2019.07.007

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