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Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika and multiple arboviral immunity

2018; Elsevier BV; Volume: 397; Linguagem: Inglês

10.1016/j.jns.2018.10.031

1878-5883

Sora Yasri, Viroj Wiwanitkit,

Long-Term Effects of COVID-19

Dear Editor, we read the clinical case report by et al. on “Concurrent Guillain-Barré syndrome (GBS), transverse myelitis and encephalitis post-Zika and multiple arboviral immunity [ [1] Mancera-Páez O. Román G.C. Pardo-Turriago R. Rodríguez Y. Anaya J.M. Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: a case report and review of the pathogenic role of multiple arboviral immunity. J. Neurol. Sci. 2018 Sep 26; 395 (Epub ahead of print): 47-53https://doi.org/10.1016/j.jns.2018.09.028 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar ]” with a great interest and would like to share ideas and experience on this problem. Mancera-Páez et al. concluded that the clinical problem is induced by acute Zika virus (ZIKV) neurotropism boosted by active immunity against other arboviruses [ [1] Mancera-Páez O. Román G.C. Pardo-Turriago R. Rodríguez Y. Anaya J.M. Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: a case report and review of the pathogenic role of multiple arboviral immunity. J. Neurol. Sci. 2018 Sep 26; 395 (Epub ahead of print): 47-53https://doi.org/10.1016/j.jns.2018.09.028 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar ]. Indeed, the concurrence is possible and might be directly due to Zika virus or might be the result of concurrent Zika virus infection and other medical disorders that can result in neurological complication. The cross immunological reaction induced neurological complication is possible. Nevertheless, in endemic area of Zika virus, such as our setting in Indochina, the concurrent immunoreactivity to Zika virus and other arboviruses such as dengue and Chikungunya virus is very common [ [2] Wikan N. Suputtamongkol Y. Yoksan S. Smith D.R. Auewarakul P. Immunological evidence of Zika virus transmission in Thailand. Asian Pac J Trop Med. 2016 Feb; 9: 141-144 Google Scholar ] but there has never been any report on the clinical problem in the case with co-reactivity between Zika virus and other arbovirus. Regarding GBS, with emerging Zika virus infection and increased number of the patient, there is no increased in the incidence of GBS or other arbovirus related neurological disorder in our setting [ [3] Joob B. Wiwanitkit V. Incidence of Guillain-Barré syndrome among Zika virus infected cases: a report from Thailand. Arq. Neuropsiquiatr. 2018 Jan; 76: 63 Google Scholar ]. Nevertheless, Mancera-Páez mentioned for the possible relationship with vaccination [ [1] Mancera-Páez O. Román G.C. Pardo-Turriago R. Rodríguez Y. Anaya J.M. Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: a case report and review of the pathogenic role of multiple arboviral immunity. J. Neurol. Sci. 2018 Sep 26; 395 (Epub ahead of print): 47-53https://doi.org/10.1016/j.jns.2018.09.028 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar ]. In our setting, the dengue virus vaccination has already been implemented and there is still no observation on the clinical problem that shows interrelationship between the vaccination and ZIKV infection or ZIKV related neurological complication.