Pediatr. praxi. 2014;15(5):291-293
Secondary vasculitis in a 4-year-old girl
- 1 Neurologická klinika FN a LF UK Hradec Králové
- 2 Dětská klinika FN a LF UK Hradec Králové
- 3 Neurologie Hradec Králové
- 4 Radiodiagnostická klinika FN a LF UK Hradec Králové
- 5 Klinika infekčních nemocí FN a LF UK Hradec Králové
We report a case of a 4-year-old girl who developed focal neurological symptoms six weeks after having a varicella infection. MR angiography
(MRA) showed changes characteristic for CNS vasculitis. The girl was treated with intravenous corticosteroids followed by oral
ones, which resulted in regression of the neurological symptoms. Three months after termination of corticosteroid therapy, there was
recurrence of vasculitic injury to the CNS and, according to follow-up MR angiography, treatment with intravenous pulses of methylprednisolone
was repeated. Subsequent treatment with oral methylprednisolone was maintained for four months. Given the high titres
of antibodies to varicella-zoster virus (VZV) in serum and the recent varicella infection, antivirotic therapy (aciclovir) was indicated.
Repeated MRA scans of the brain revealed regression of the vasculitic changes without evidence of new ischaemia. Clinically, the girl is
in a good condition, has started attending a preschool facility and remained on regular neurological follow-up.
Keywords: CNS vasculitis, varicella, ischaemia, methylprednisolone, aciclovir
Published: October 25, 2014 Show citation
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