CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1600806
Longitudinally extensive transverse myelitis as a manifestation of neurochikungunya in a lupus patient: a case report
Provisionally accepted
Emanuelle de Matos Rodrigues1Lysiane Maria Adeodato Ramos Fontenelle2Andrea Rocha de Saboia MontAlverne2Kirla Wagner Poti Gomes1Samia Araújo de Sousa Studart1Beatriz Rodrigues Neri3
CARLOS Ewerton Maia RODRIGUES2*- 1Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil
- 2Graduate Program in Medical Sciences, University of Fortaleza (Unifor), University of Fortaleza, Fortaleza, Brazil
- 3University of Fortaleza, Fortaleza, Brazil
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Myeloneuropathy is rare complication of Chikungunya virus (CHIKV) infection which may have an underlying immune-mediated pathogenesis. Case Presentation: We describe a 31-year old female patient with systemic lupus erythematosus (SLE) presenting with acute/hyperacute bulbar and medullary fever syndrome with ascending tetraparesis associated with arthritis, requiring differential diagnosis. The analysis of the cerebrospinal fluid (CSF) revealed inflammatory markers, high protein levels, high lymphocyte and neutrophil counts, and reduced glucose. Neuroimaging showed amorphous foci of hyperintensity in T2, suggesting extensive medullary edema, especially in the central region, with no significant contrast enhancement, along with areas of medullary atrophy consistent with holocord longitudinally extensive transverse myelitis and periventricular and periaqueductal involvement. CHIKV IgM antibodies were also detected in the CSF. Conclusion: The present case highlights the importance of investigating atypical neurological syndromes in SLE and of including CHIKV infection, though rare, in the differential diagnosis of patients from endemic regions in order to minimize morbidity and mortality.
Keywords: systemic lupus erythematosus, Chikungunya virus, Transverse myelitis, Myeloneuropathy, Outcome
Received: 27 Mar 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Rodrigues, Fontenelle, MontAlverne, Gomes, Studart, Neri and RODRIGUES. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: CARLOS Ewerton Maia RODRIGUES, Graduate Program in Medical Sciences, University of Fortaleza (Unifor), University of Fortaleza, Fortaleza, Brazil
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.