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Acute flaccid paralysis due to Echovirus 30 in an immunosuppressed transplant recipient

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Abstract

An Italian 13-year-old boy immunosuppressed due to kidney transplant presented in November 2018 with acute flaccid paralysis with anterior horn cell involvement resembling the clinical, radiological, and laboratory features of poliomyelitis. Enterovirus was molecularly identified in cerebral spinal fluid and stool samples and the sequence analysis of the VP1 gene of enterovirus genome revealed the presence of Echovirus 30 both in CSF and in stool samples. Echovirus 30 is an emerging neurotropic virus able to cause outbreaks of aseptic meningitis and meningoencephalitis all over the world, but acute flaccid paralysis is not a classical manifestation. A 6-month follow-up revealed a poor outcome with severe motor deficits and only slight improvement in disability. Clinicians must be aware of the possible role of Echovirus 30 in acute flaccid paralysis and active surveillance should consider the possible influence of immunosuppression on the symptoms caused by the widening spectrum of enterovirus infections.

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Acknowledgments

The authors would like to thank the family members for their cooperation.

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Authors and Affiliations

  1. Dino Ferrari Centre, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy

    Eleonora Mauri

  2. Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy

    Antonio Mastrangelo, Sara Testa & Giovanni Montini

  3. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy

    Laura Pellegrinelli, Elena Pariani & Sandro Binda

  4. Neuroradiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy

    Fabio Triulzi

  5. Clinical Neurophysiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    Sergio Barbieri, Cristina Bana & Robertino Dilena

  6. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

    Giovanni Montini

  7. Clinical Neurophysiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122, via Francesco Sforza 35, Milan, Italy

    Robertino Dilena

Authors
  1. Eleonora Mauri
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  2. Antonio Mastrangelo
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  3. Sara Testa
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  4. Laura Pellegrinelli
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  5. Elena Pariani
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  6. Sandro Binda
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  7. Fabio Triulzi
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  8. Sergio Barbieri
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  9. Cristina Bana
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  10. Giovanni Montini
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  11. Robertino Dilena
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Corresponding author

Correspondence to Robertino Dilena.

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All the authors declare that they have no conflict of interest.

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Mauri, E., Mastrangelo, A., Testa, S. et al. Acute flaccid paralysis due to Echovirus 30 in an immunosuppressed transplant recipient. J. Neurovirol. 26, 284–288 (2020). https://doi.org/10.1007/s13365-019-00812-4

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  • DOI: https://doi.org/10.1007/s13365-019-00812-4

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