Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis

Abstract CNS cryptococcal meningoencephalitis in both HIV positive (HIV+) and HIV negative (HIV−) subjects is associated with high morbidity and mortality despite optimal antifungal therapy. We thus conducted a detailed analysis of the MR imaging findings in 45 HIV− and 11 HIV+ patients to identify...

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Autores principales:	Dima A. Hammoud, Eman Mahdi, Anil A. Panackal, Paul Wakim, Virginia Sheikh, Irini Sereti, Bibi Bielakova, John E. Bennett, Peter R. Williamson
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4a12d351f65f45fe9eb7512182e0f8b2
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spelling	oai:doaj.org-article:4a12d351f65f45fe9eb7512182e0f8b22021-12-02T11:52:28ZChoroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis10.1038/s41598-017-09694-02045-2322https://doaj.org/article/4a12d351f65f45fe9eb7512182e0f8b22017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-09694-0https://doaj.org/toc/2045-2322Abstract CNS cryptococcal meningoencephalitis in both HIV positive (HIV+) and HIV negative (HIV−) subjects is associated with high morbidity and mortality despite optimal antifungal therapy. We thus conducted a detailed analysis of the MR imaging findings in 45 HIV− and 11 HIV+ patients to identify imaging findings associated with refractory disease. Ventricular abnormalities, namely ependymitis and choroid plexitis were seen in HIV− but not in HIV+ subjects. We then correlated the imaging findings in a subset of HIV− subjects (n = 17) to CSF levels of neurofilament light chain (NFL), reflective of axonal damage and sCD27, known to best predict the presence of intrathecal T-cell mediated inflammation. We found that ependymitis on brain MRI was the best predictor of higher log(sCD27) levels and choroid plexitis was the best predictor of higher log(NFL) levels. The availability of predictive imaging biomarkers of inflammation and neurological damage in HIV− subjects with CNS cryptococcosis may help gauge disease severity and guide the therapeutic approach in those patients.Dima A. HammoudEman MahdiAnil A. PanackalPaul WakimVirginia SheikhIrini SeretiBibi BielakovaJohn E. BennettPeter R. WilliamsonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dima A. Hammoud Eman Mahdi Anil A. Panackal Paul Wakim Virginia Sheikh Irini Sereti Bibi Bielakova John E. Bennett Peter R. Williamson Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
description	Abstract CNS cryptococcal meningoencephalitis in both HIV positive (HIV+) and HIV negative (HIV−) subjects is associated with high morbidity and mortality despite optimal antifungal therapy. We thus conducted a detailed analysis of the MR imaging findings in 45 HIV− and 11 HIV+ patients to identify imaging findings associated with refractory disease. Ventricular abnormalities, namely ependymitis and choroid plexitis were seen in HIV− but not in HIV+ subjects. We then correlated the imaging findings in a subset of HIV− subjects (n = 17) to CSF levels of neurofilament light chain (NFL), reflective of axonal damage and sCD27, known to best predict the presence of intrathecal T-cell mediated inflammation. We found that ependymitis on brain MRI was the best predictor of higher log(sCD27) levels and choroid plexitis was the best predictor of higher log(NFL) levels. The availability of predictive imaging biomarkers of inflammation and neurological damage in HIV− subjects with CNS cryptococcosis may help gauge disease severity and guide the therapeutic approach in those patients.
format	article
author	Dima A. Hammoud Eman Mahdi Anil A. Panackal Paul Wakim Virginia Sheikh Irini Sereti Bibi Bielakova John E. Bennett Peter R. Williamson
author_facet	Dima A. Hammoud Eman Mahdi Anil A. Panackal Paul Wakim Virginia Sheikh Irini Sereti Bibi Bielakova John E. Bennett Peter R. Williamson
author_sort	Dima A. Hammoud
title	Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
title_short	Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
title_full	Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
title_fullStr	Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
title_full_unstemmed	Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis
title_sort	choroid plexitis and ependymitis by magnetic resonance imaging are biomarkers of neuronal damage and inflammation in hiv-negative cryptococcal meningoencephalitis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/4a12d351f65f45fe9eb7512182e0f8b2
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Choroid Plexitis and Ependymitis by Magnetic Resonance Imaging are Biomarkers of Neuronal Damage and Inflammation in HIV-negative Cryptococcal Meningoencephalitis

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