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Acta Neuropathol. 2019 Oct;138(4):653-665. doi: 10.1007/s00401-019-02047-3. Epub 2019 Jul 26.

The neuropathology of fatal encephalomyelitis in human Borna virus infection.

Author information

1
Department of Neuropathology, School of Medicine, Institute of Pathology, Technical University Munich, Trogerstraße 18, 81675, Munich, Germany. friederike.liesche@tum.de.
2
Center for Neuropathology and Prion Research, Ludwig-Maximilians-Universitaet München, Munich, Germany.
3
Department of Neuropathology, University of Regensburg, Regensburg, Germany.
4
Department of Neuropathology, School of Medicine, Institute of Pathology, Technical University Munich, Trogerstraße 18, 81675, Munich, Germany.
5
Section of Clinical and Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians Universitaet München, Munich, Germany.
6
Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany.
7
Institute of Veterinary Pathology, Justus Liebig University, Giessen, Germany.
8
Division of Medicine and Reproduction, Equine Hospital, Ludwig-Maximilians Universitaet München, Munich, Germany.
9
Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, Munich, Germany.
10
Department of Pediatrics, Medical Faculty, Augsburg University, Augsburg, Germany.
11
Department of Neurology, Klinikum Traunstein, Traunstein, Germany.
12
Department of Pathology, Klinikum Traunstein, Traunstein, Germany.
13
Department of Pathology, Municipal Hospital Landshut, Landshut, Germany.
14
Department of Neurology, Municipal Hospital Landshut, Landshut, Germany.
15
Department of Neurology, Regensburg University Hospital, Regensburg, Germany.
16
Institute of Pathology, Medical Faculty, Augsburg University, Augsburg, Germany.
17
Department of Internal Medicine II, Municipal Hospital Landshut, Landshut, Germany.
18
Institute of Clinical Microbiology and Hygiene, Regensburg University Hospital, Regensburg, Germany.
19
Institute of Pathology, University of Regensburg, Regensburg, Germany.
20
Munich Cluster of Systems Neurology (SyNergy), Munich, Germany.

Abstract

After many years of controversy, there is now recent and solid evidence that classical Borna disease virus 1 (BoDV-1) can infect humans. On the basis of six brain autopsies, we provide the first systematic overview on BoDV-1 tissue distribution and the lesion pattern in fatal BoDV-1-induced encephalitis. All brains revealed a non-purulent, lymphocytic sclerosing panencephalomyelitis with detection of BoDV-1-typical eosinophilic, spherical intranuclear Joest-Degen inclusion bodies. While the composition of histopathological changes was constant, the inflammatory distribution pattern varied interindividually, affecting predominantly the basal nuclei in two patients, hippocampus in one patient, whereas two patients showed a more diffuse distribution. By immunohistochemistry and RNA in situ hybridization, BoDV-1 was detected in all examined brain tissue samples. Furthermore, infection of the peripheral nervous system was observed. This study aims at raising awareness to human bornavirus encephalitis as differential diagnosis in lymphocytic sclerosing panencephalomyelitis. A higher attention to human BoDV-1 infection by health professionals may likely increase the detection of more cases and foster a clearer picture of the disease.

KEYWORDS:

Borna disease virus (BoDV-1); Bornavirus; Encephalitis; Virus; Zoonosis

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