寨卡病毒感染

格林-巴利综合征 (GBS) 以及其他神经系统疾病与寨卡病毒相关性很高，且疑似由寨卡病毒感染引起，但其中的关联尚未确立，有关于此的研究正在进行中，包括阐明其中可能的机制。[9]Dos Santos T, Rodriguez A, Almiron M, et al. Zika virus and the Guillain-Barré syndrome - case series from seven countries. N Engl J Med. 2016 Oct 20;375(16):1598-601. http://www.nejm.org/doi/full/10.1056/NEJMc1609015?query=featured_zika http://www.ncbi.nlm.nih.gov/pubmed/27579558?tool=bestpractice.com [10]Parra B, Lizarazo J, Jiménez-Arango JA, et al. Guillain-Barré syndrome associated with Zika virus infection in Colombia. N Engl J Med. 2016 Oct 20;375(16):1513-23. http://www.nejm.org/doi/full/10.1056/NEJMoa1605564#t=article http://www.ncbi.nlm.nih.gov/pubmed/27705091?tool=bestpractice.com [11]Frontera JA, da Silva IR. Zika getting on your nerves? The association with the Guillain-Barré syndrome. N Engl J Med. 2016 Oct 20;375(16):1581-82. http://www.nejm.org/doi/full/10.1056/NEJMe1611840 http://www.ncbi.nlm.nih.gov/pubmed/27705077?tool=bestpractice.com [12]Leis AA, Stokic DS. Zika virus and Guillain–Barre syndrome: is there sufficient evidence for causality? Front Neurol. 2016 Sep 30;7:170. http://journal.frontiersin.org/article/10.3389/fneur.2016.00170/full http://www.ncbi.nlm.nih.gov/pubmed/27746763?tool=bestpractice.com

目前的证据估计格林-巴利综合征的发病率为 24 例/100,000 寨卡病毒感染者。[44]Uncini A, Shahrizaila N, Kuwabara S. Zika virus infection and Guillain-Barré syndrome: a review focused on clinical and electrophysiological subtypes. J Neurol Neurosurg Psychiatry. 2017 Mar;88(3):266-271. http://www.ncbi.nlm.nih.gov/pubmed/27799296?tool=bestpractice.com

寨卡病毒感染患者中报告了急性脊髓炎、脑膜脑炎和急性播散性脑脊髓炎的病例。[214]American Academy of Neurology. Zika virus may now be tied to another brain disease. April 2016 [internet publication]. https://www.aan.com/PressRoom/Home/PressRelease/1451 [215]Barcellos C, Xavier DR, Pavão AL, et al. Increased hospitalizations for neuropathies as indicators of Zika virus infection, according to health information system data, Brazil. Emerg Infect Dis. 2016 Nov;22(11):1894-9. https://wwwnc.cdc.gov/eid/article/22/11/16-0901_article http://www.ncbi.nlm.nih.gov/pubmed/27603576?tool=bestpractice.com [216]Soares CN, Brasil P, Carrera RM, et al. Fatal encephalitis associated with Zika virus infection in an adult. J Clin Virol. 2016 Oct;83:63-5. http://www.ncbi.nlm.nih.gov/pubmed/27598870?tool=bestpractice.com [217]Niemeyer B, Niemeyer R, Borges R, et al. Acute disseminated encephalomyelitis following Zika virus infection. Eur Neurol. 2017;77(1-2):45-6. http://www.ncbi.nlm.nih.gov/pubmed/27894121?tool=bestpractice.com

有一例寨卡病毒仍存在于血清中时，即出现迅速进展的急性脱髓鞘性多神经病病例得以报道。[119]Siu R, Bukhari W, Todd A, et al. Acute Zika infection with concurrent onset of Guillain-Barré syndrome. Neurology. 2016 Jun;7(2):220. http://www.neurology.org/content/early/2016/07/27/WNL.0000000000003038.long http://www.ncbi.nlm.nih.gov/pubmed/27466468?tool=bestpractice.com

有一例急性感染阶段出现急性感觉性多神经病变病例得以报道。[218]Medina MT, England JD, Lorenzana I, et al. Zika virus associated with sensory polyneuropathy. J Neurol Sci. 2016 Oct 15;369:271-2. http://www.jns-journal.com/article/S0022-510X(16)30535-4/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27653905?tool=bestpractice.com

格林-巴利综合征

在部分有寨卡病毒感染的女性中报道了流产发生。[219]van der Eijk AA, van Genderen PJ, Verdijk RM, et al. Miscarriage associated with Zika virus infection. N Engl J Med. 2016 Sep 8;375(10):1002-4. https://www.nejm.org/doi/full/10.1056/NEJMc1605898 http://www.ncbi.nlm.nih.gov/pubmed/27463941?tool=bestpractice.com

流产

根据某些病例报道，这可能是寨卡病毒感染的一种可能表现。[220]Furtado JM, Espósito DL, Klein TM, et al. Uveitis associated with Zika virus infection. N Engl J Med. 2016 Jul 28;375(4):394-6. http://www.nejm.org/doi/full/10.1056/NEJMc1603618 http://www.ncbi.nlm.nih.gov/pubmed/27332784?tool=bestpractice.com [221]Kodati S, Palmore TN, Spellman FA, et al. Bilateral posterior uveitis associated with Zika virus infection. Lancet. 2017 Jan 7;389(10064):125-6. http://www.ncbi.nlm.nih.gov/pubmed/27939402?tool=bestpractice.com 患者眼球水状液的逆转录聚合酶链反应 (RT-PCR) 呈寨卡病毒 RNA 阳性。两例寨卡病毒相关的双侧高血压性急性前葡萄膜炎被加以报道。[222]Merle H, Najioullah F, Chassery M, et al. Zika-related bilateral hypertensive anterior acute uveitis. JAMA Ophthalmol. 2017 Mar 1;135(3):284-5. http://www.ncbi.nlm.nih.gov/pubmed/28152146?tool=bestpractice.com

葡萄膜炎

一例一过性心肌炎被认为是寨卡病毒感染所致。[223]Aletti M, Lecoules S, Kanczuga V, et al. Transient myocarditis associated with acute Zika virus infection. Clin Infect Dis. 2017 Mar 1;64(5):678-9. http://www.ncbi.nlm.nih.gov/pubmed/27940942?tool=bestpractice.com 其他寨卡病毒感染相关心血管并发症包括心律失常、心力衰竭以及心包积液。[224]Gonzalez Carta KA, Mendoza I, Morr I, et al. Myocarditis, heart failure and arrhythmias in patients with Zika. Presented at American College of Cardiology 2017 Annual Conference; March 17-19, 2017; Washington, DC. http://www.abstractsonline.com/pp8/#!/4223/presentation/35844

一项研究发现，寨卡病毒感染可能会导致患先天性心脏疾病的风险有所增加，不过还需进一步研究。[225]Cavalcanti DD, Alves LV, Furtado GJ, et al. Echocardiographic findings in infants with presumed congenital Zika syndrome: retrospective case series study. PLoS One. 2017 Apr 20;12(4):e0175065. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175065 http://www.ncbi.nlm.nih.gov/pubmed/28426680?tool=bestpractice.com

心肌炎