Unusual association of diseases/symptoms: Encephalitis with herpes simplex-2 in the cerebrospinal fluid and anti-RI (ANNA-2) antibodies: an infectious or a paraneoplastic syndrome?

We report on a 70-year-old woman with partial complex status epilepticus who was initially diagnosed with herpes simplex-2 (HSV-2) encephalitis, based on brain magnetic resonance imaging (MRI) findings, cerebrospinal fluid (CSF) lymphocytic pleocytosis and HSV-2 DNA detection by polymerase chain reaction (PCR) in the CSF, but without improvement on intravenous acyclovir. Anti-Ri antibodies were positive and computed tomography (CT) investigations revealed a small cell carcinoma at biopsy suggesting paraneoplastic encephalitis. The outcome was unfavourable and the autopsy showed typical features of paraneoplastic encephalitis but no evidence of viral inclusions. This case report is interesting because: (1) it is the first report of an autopsy proven paraneoplastic widespread encephalitis with anti-Ri antibodies; (2) despite a positive HSV-2 PCR in the CSF, there was no sign of herpetic infections of the nervous system; and (3) it illustrates the fact that if paraneoplastic antibodies are usually good markers of the underlying tumour, they are not always predictive of neurological deficits.

Yliopistosivistyneistön asema ja tehtävät yhteiskunnassa

Kirjoitus perustuu juhlaesitelmään Suomen akateemisten tutkijoiden (SATY) 30-vuotisseminaarissa 6.9.2002.

Hyvinvointiyhteiskunta ja oikeudellinen ympäristö

Lectio praecursoria Helsingin yliopistossa 23.11.2002 pidetyssä väitöstilaisuudessa, jossa kirjoittaja puolusti väitöskirjaansa Toimeentuloturvan oikeellisuus

Euroeliitissä vai politiikan sivuraiteilla? : europarlamentaarikoiden asema suomalaisessa valtarakenteessa

Abstract: In the euro-elite or in the wilderness of politics? Position of MEP's in the Finnish power structure