Childhood chronic inflammatory demyelinating polyneuropathy secondary to reactivation of Epstein-Barr virus

Abstract

A case of childhood chronic inflammatory demyelinating polyneuropathy (CIDP) due to Epstein-Barr virus (EBV) infection is reported. A 15-year-old male presented with CIDP, which initially mimicked Guillain-Barré syndrome. He subsequently developed major relapses at four and five months after initial presentation. He recovered six weeks after the last relapse. Serological studies showed positive Epstein-Barr nuclear antigen IgG and negative EBV viral capsid antigen IgM. However, EBV deoxyribonucleic acid was detected by polymerase chain reaction from cerebrospinal fluid, measuring up to 1000 copies/mL. His CIDP, which ran a relapsing course, could be explained by reactivation of latent EBV, triggered by other viral illness. Given patient's full recovery, the mechanism of injury is likely due to EBV-associated immune-mediated process, rather than from a direct viral infiltration of the peripheral nerve. This is the first report of a CIDP with documented EBV infection in cerebrospinal fluid.

Keywords

Chronic inflammatory demyelinating polyneuropathy - Guillain-Barré syndrome - Epstein-Barr virus