Open AccessCOVID‐19‐associated immune‐mediated encephalitis mimicking acute‐onset Creutzfeldt‐Jakob disease
Author(s) -
Beretta Simone,
Stabile Andrea,
Balducci Claudia,
DiFrancesco Jacopo C.,
Patruno Adriana,
Rona Roberto,
Bombino Michela,
Capraro Cristina,
Andreetta Francesca,
Cavalcante Paola,
Moda Fabio,
Citerio Giuseppe,
Foti Giuseppe,
Bogliun Graziella,
Ferrarese Carlo
Publication year - 2021
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.51479
Subject(s) - medicine , hyperintensity , myoclonus , encephalitis , pneumonia , electroencephalography , aphasia , covid-19 , immune system , cerebrospinal fluid , confusion , disease , pathology , immunology , magnetic resonance imaging , virus , anesthesia , infectious disease (medical specialty) , psychiatry , radiology , psychology , psychoanalysis
We report a subtype of immune‐mediated encephalitis associated with COVID‐19, which closely mimics acute‐onset sporadic Creutzfeldt–Jakob disease. A 64‐year‐old man presented with confusion, aphasia, myoclonus, and a silent interstitial pneumonia. He tested positive for SARS‐CoV‐2. Cognition and myoclonus rapidly deteriorated, EEG evolved to generalized periodic discharges and brain MRI showed multiple cortical DWI hyperintensities. CSF analysis was normal, except for a positive 14‐3‐3 protein. RT‐QuIC analysis was negative. High levels of pro‐inflammatory cytokines were present in the CSF and serum. Treatment with steroids and intravenous immunoglobulins produced EEG and clinical improvement, with a good neurological outcome at a 6‐month follow‐up.