Subacute sclerosing panencephalitis: the continuing threat

Vilibić Čavlek, Tatjana and Ljubin Sternak, Sunčanica and Žarković, Kamelija and Marušić Della Marina, Branka and Cvitanović Šojat, Ljerka and Bašnec, Anica and Kaić, Bernard and Turković, Branko and Mlinarić Galinović, Gordana (2006) Subacute sclerosing panencephalitis: the continuing threat. Collegium Antropologicum, 30 (4). pp. 959-963. ISSN 0350-6134

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Abstract

Clinical, epidemiological and laboratory findings of four patients with subacute sclerosing panencephalitis (SSPE), diagnosed in Croatia in 2002, were examined. Patient age at disease onset ranged from 5-11 years. All patients were vaccinated regularly with MMR-vaccine. Two patients had a history of measles infection at the age of six and seven months, respectively. In the other two patients, the disease started immediately after the varicella infection. Complement fixing antibody titre to the measles virus (MV) ranged from 1:1024 to 1:65536 in serum, and from 1:16 to 1:128 in cerebrospinal fluid (CSF). In CSF, no antibodies to varicella-zoster virus were found. Brain tissue samples were obtained at autopsy from two patients. In one patient, electron microscopy demonstrated intranuclear viral inclusions (MV nucleocapsids). MV antigen was detected in brain imprints using IFA in both of them. Viral RNA was found in brain tissue samples only, while plasma, serum and CSF were negative. Nucleotide sequence analysis showed that the viruses detected in brain tissue belong to the wild-type MV D6 genotype.

Abstract in Croatian

Analizirani su klinički, epidemiološki i laboratorijski nalazi četvero bolesnika sa subakutnim sklerozirajućim panencefalitisom (SSPE) u Hrvatskoj tijekom 2002 godine. Dob bolesnika iznosila je od 5–11 godina. Svi su bolesnici redovno cijepljeni protiv morbila (Morbili-Parotitis-Rubela cjepivo). Dvoje bolesnika je imalo anamnestički podatak o preboljelim morbilima u dobi od šest odnosno sedam mjeseci. U druga je dva bolesnika bolest počela neposredno nakon preboljelih vodenih kozica. Titar komplement-fiksirajućih protutijela na virus morbila (MV) iznosio je od 1:1024 do 1:65536 u serumu te od 1:16 do 1:128 u cerebrospinalnom likvoru (CSL). Protutijela na virus varicella-zoster u CSL nisu nađena. Postmortalno su dobiveni uzorci moždanog tkiva od dvoje bolesnika. U jednog je bolesnika elektronska mikroskopija pokazala intranuklearne virusne inkluzije (MV nukleokapside). Metodom IFA, MV antigen dokazan je u moždanom otisku u oba bolesnika. Virusna RNA nađena je samo u uzorcima moždanog tkiva, dok su plazma, serum i CSL bili negativni. Analizom sekvenci nukleotida dokazan je divlji tip MV D6 genotipa14.

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