Abstract | INTRODUCTION: 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.
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Authors | Ching-Fu Weng, Ding-Cheng Chan, Ya-Fang Chen, Fei-Chih Liu, Horng-Huei Liou |
Journal | Journal of medical case reports
(J Med Case Rep)
Vol. 9
Pg. 266
(Nov 19 2015)
ISSN: 1752-1947 [Electronic] England |
PMID | 26582039
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Adrenal Cortex Hormones
(therapeutic use)
- Adult
- Demyelinating Diseases
(drug therapy)
- Encephalomyelitis
(drug therapy)
- Hepatitis B, Chronic
(complications)
- Humans
- Magnetic Resonance Imaging
- Male
- Neuroimaging
- Pons
(physiopathology)
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