Chronic Herpes Simplex Virus Encephalitis: Two Surgical Cases with Novel Neuropathologic Findings (P12-10.001)
Notice bibliographique
Résumé
Objective: N/A Background: Chronic granulomatous herpes simplex encephalitis (CGHSE) is a rare complication following infantile and pediatric herpes simplex virus encephalitis (HSVE). Clinically, it follows a biphasic course, with acute HSVE later followed by drug-resistant seizures and progressive neurologic deterioration. Convincing evidence is lacking for whether CGHSE occurs due to virus reactivation versus post-infectious inflammatory sequelae. Design/Methods: The neuropathologic findings of two patients who underwent epilepsy surgery following remote infectious encephalitis are herein discussed. The first case is previously unreported and confirmed to be associated with HSV-I, and the second case, newly re-examined, is previously reported and of presumed HSV-I encephalitis. Results: The histological findings in the current cases were consistent with chronic, ongoing inflammation, both of which harboured parenchymal HSV-I DNA by PCR. There were no HSV antigens detected via immunohistochemistry nor viral inclusions seen on the H&E sections. A novel finding, shared by both cases, is the identification of cytoplasmic phosphorylated tau-immunopositive components: neurofibrillary tangles, pretangles and neuropil threads. These were demonstrated within regions of inflammation as well as seemingly uninvolved areas. Conclusions: Tau hyperphosphorylation has been reported following other infections, such as post-measles subacute sclerosing panencephalitis and HIV-associated neurocognitive disorders. HSV-I infection has been postulated to promote tau protein hyperphosphorylation. HSV-I primary infection and reactivation have been associated with phosphorylated tau accumulation in murine models. HSV-I in vitro infection models exposed to acyclovir treatment demonstrate dose-dependent reductions in phosphorylated tau accumulation. While in vitro murine, monkey and human experimental data have demonstrated hyperphosphorylated tau accumulates following HSV-I infection, to our knowledge, this may represent the first patient report of abnormal phosphorylated tau accumulation associated with neuropathologic chronic granulomatous HSVE. Further investigation into the possibility that tau accumulation contributes to long-term neurologic sequelae among HSVE survivors may be warranted. Disclosure: Dr. Sjonnesen has nothing to disclose. Dr. Appendino has nothing to disclose. Walter J. Hader, MD has nothing to disclose. Dr. Xu has nothing to disclose. The institution of Prof. Jacobs has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for UCB. Prof. Jacobs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Epilog. Prof. Jacobs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Prof. Jacobs has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pendopharm. Prof. Jacobs has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Prof. Jacobs has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Prof. Jacobs has received research support from Alberta Childrens Hospital Foundation. Dr. Federico has nothing to disclose. Dr. Langdon has nothing to disclose.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».