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Syndrome of Transie...
Syndrome of Transient Headache and Neurologic Deficits with Cerebrospinal Fluid Lymphocytosis (HaNDL): HHV-7 Finding in Cerebrospinal Fluid Challenges Diagnostic Criteria
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- Sundholm, A (författare)
- Karolinska Institutet
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- Gustafsson, R (författare)
- Karolinska Institutet
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- Karrenbauer, V (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2023-03-17
- 2023
- Engelska.
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Ingår i: Pathogens (Basel, Switzerland). - : MDPI AG. - 2076-0817. ; 12:3
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http://kipublication...
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https://doi.org/10.3...
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Abstract
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- The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is a rare, self-limiting condition with severe headaches combined with neurological symptoms. However, evidence-based recommendations on diagnostics and treatments are unavailable due to the condition’s rarity and unknown pathophysiology. A young man experiencing severe headache attacks fulfilled the HaNDL diagnostic criteria according to the third edition of the International Classification of Headache Disorders (ICHD-3). We present the dynamics of cerebrospinal fluid (CSF) biomarkers related to low human herpesvirus 7 (HHV-7) load and anti-inflammatory treatment outcomes. Low HHV-7 load may be an immunological trigger of HaNDL, such that elevated levels of CSF- chemokine (C-X-C motif) ligand 13 open a new way to interpret the role of B cells in HaNDL pathogenesis. We discuss the diagnostic challenge of HaNDL, according to the ICHD-3, in the case of pathogen presence at low load in CSF.
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