Significant T Lymphocyte Response in Acute Disseminated Encephalomyelitis: a Case Report

Background: Acute disseminated encephalomyelitis is an acute onset, rapid progress immune-mediated demyelinating disease of the central nervous system. In 50-80% of the patients, cerebrospinal fluid analysis was abnormal. Some studies suggest that molecular simulation mechanism or direct infection of the central nervous system can cause autoimmune tolerance damage, resulting in perivascular inflammatory response and paraventricular demyelination in acute disseminated encephalomyelitis. Both the two cause the activation of T lymphocytes, leading to the imaging lesions and clinical manifestations. Case presentation: Herein we report an old man who presented acute disseminated encephalomyelitis without prodromal infection or vaccination injection history. We focused on the changes of lymphocyte subsets in cerebrospinal fluid and peripheral blood during the course of the disease to explore the potential immunological mechanisms of the disease. Conclusion: We found that cerebrospinal fluid and peripheral blood lymphocyte counts were significantly higher in patients during the acute phase of the disease, with a predominance of T lymphocytes. While methylprednisolone therapy plays a powerful role in suppressing T cell activation and autoimmune diseases, but the detailed molecular mechanisms still need further investigation.