West nile virus meningoencephalitis and acute flaccid paralysis after infliximab treatment

West Nile virus (WNV) can cause severe central nervous system (CNS) illnesses including meningoencephalitis (MNE) and acute flaccid paralysis (AFP). Risk factors include advanced age, immunosuppression, cancer, and diabetes. In vitro studies show that tumor necrosis factor (TNF) has anti-WNV activit...

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Bibliographic Details
Published in:Journal of rheumatology 2006-01, Vol.33 (1), p.191-192
Main Authors: CHAN-TACK, Kirk M, FORREST, Graeme
Format: Article
Language:English
Subjects:
Aged
Antibodies, Monoclonal - adverse effects
Antibodies, Viral - cerebrospinal fluid
Biological and medical sciences
Diseases of the osteoarticular system
Fatal Outcome
Humans
Immunocompromised Host
Immunomodulators
Immunosuppressive Agents - adverse effects
Infliximab
Male
Medical sciences
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Paraplegia - diagnosis
Paraplegia - etiology
Pharmacology. Drug treatments
West Nile Fever - complications
West Nile Fever - diagnosis
West Nile virus - immunology
West Nile virus - isolation & purification
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Summary:West Nile virus (WNV) can cause severe central nervous system (CNS) illnesses including meningoencephalitis (MNE) and acute flaccid paralysis (AFP). Risk factors include advanced age, immunosuppression, cancer, and diabetes. In vitro studies show that tumor necrosis factor (TNF) has anti-WNV activity and is protective against WNV infection. Anti-TNF-a monoclonal antibodies may increase susceptibility to WNV by inhibiting an adequate TNF-a response, leading to prolonged viremia, viral penetration into the CNS, and fulminant WNV-CNS disease. We describe a fatal case of WNV with MNE and AFP after infliximab therapy. During WNV outbreaks, clinicians should encourage patients receiving anti-TNF-a drugs to take appropriate preventive measures because of the risk of severe WNV-CNS disease.
ISSN:0315-162X
1499-2752