Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.

Abstract Background Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with seve...

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Autores principales:	Takuya Kudo, Yuichi Hayashi, Kenjiro Kunieda, Nobuaki Yoshikura, Akio Kimura, Mika Otsuki, Takayoshi Shimohata
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	SARS-CoV-2 Encephalopathy IL-8 Aphasia Case report Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ecfbcd3f50a24664b58b68b3b3283c17
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spelling	oai:doaj.org-article:ecfbcd3f50a24664b58b68b3b3283c172021-11-07T12:23:03ZPersistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.10.1186/s12883-021-02459-31471-2377https://doaj.org/article/ecfbcd3f50a24664b58b68b3b3283c172021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02459-3https://doaj.org/toc/1471-2377Abstract Background Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia. Case presentation An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy. Conclusion The cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.Takuya KudoYuichi HayashiKenjiro KuniedaNobuaki YoshikuraAkio KimuraMika OtsukiTakayoshi ShimohataBMCarticleSARS-CoV-2EncephalopathyIL-8AphasiaCase reportNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SARS-CoV-2 Encephalopathy IL-8 Aphasia Case report Neurology. Diseases of the nervous system RC346-429
spellingShingle	SARS-CoV-2 Encephalopathy IL-8 Aphasia Case report Neurology. Diseases of the nervous system RC346-429 Takuya Kudo Yuichi Hayashi Kenjiro Kunieda Nobuaki Yoshikura Akio Kimura Mika Otsuki Takayoshi Shimohata Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
description	Abstract Background Neurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia. Case presentation An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy. Conclusion The cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.
format	article
author	Takuya Kudo Yuichi Hayashi Kenjiro Kunieda Nobuaki Yoshikura Akio Kimura Mika Otsuki Takayoshi Shimohata
author_facet	Takuya Kudo Yuichi Hayashi Kenjiro Kunieda Nobuaki Yoshikura Akio Kimura Mika Otsuki Takayoshi Shimohata
author_sort	Takuya Kudo
title	Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
title_short	Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
title_full	Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
title_fullStr	Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
title_full_unstemmed	Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.
title_sort	persistent intrathecal interleukin-8 production in a patient with sars-cov-2-related encephalopathy presenting aphasia: a case report.
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ecfbcd3f50a24664b58b68b3b3283c17
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Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.

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