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PEDIATRICS Vol. 113 No. 1 January 2004, pp. e73-e76

EXPERIENCE AND REASON

Detection of Coronavirus in the Central Nervous System of a Child With Acute Disseminated Encephalomyelitis

E. Ann Yeh, MD, MA*, Arlene Collins, PhD{ddagger}, Michael E. Cohen, MD*, Patricia K. Duffner, MD* and Howard Faden, MD§

* Departments of Neurology
{ddagger} Microbiology
§ Pediatrics, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York

We present a case in which human coronavirus was detected in the cerebrospinal fluid of a child presumed to have acute disseminated encephalomyelitis. In murine models, coronavirus has been found to cause a chronic demyelinating condition that resembles multiple sclerosis. Additionally, there is in vitro evidence of human coronavirus’s ability to infect neural cells. This case report provides additional support for the hypothesis that coronavirus may be an important etiologic factor in the pathogenesis of demyelinating disease in humans.

Key Words: coronavirus • HCoV • acute disseminated encephalomyelitis • ADEM • postinfectious encephalitis • demyelination • child

Abbreviations: ADEM, acute disseminated encephalomyelitis • CNS, central nervous system • MRI, magnetic resonance imaging • CSF, cerebrospinal fluid • PCR, polymerase chain reaction • IgG, immunoglobulin G • RT, reverse transcription • HCoV, human coronavirus • MS, multiple sclerosis

Received for publication Jun 13, 2003; Accepted Sep 4, 2003.


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