|
|
|
| Diagnosis and treatment of a cases with influenza-associated acute necrotizing encephalopathy and review of relevant literature and review of relevant literature |
| SUN Wenqiang1 ZHU Xueping1 FU Changchang1 LI Ying2 SHENG Mao3 |
1.Department of Neonatology, Children’s Hospital of Soochow University, Jiangsu Province, Suzhou 215025, China;
2.Department of Intensive Care Unit, Children’s Hospital of Soochow University, Jiangsu Province, Suzhou 215025, China;
3.Department of Imaging, Children’s Hospital of Soochow University, Jiangsu Province, Suzhou 215025, China
|
|
|
|
Abstract influenza-associated acute necrotizing encephalopathy (IANE) is one of the most critical subtypes of an acute encephalopathy, progressing rapidly, with fever, convulsions, and rapid onset of consciousness the most common, and with a poor prognosis. In order to improve clinicians’ ability to recognize and diagnose IANE at an early stage, ensure timely treatment of patients and improve their prognosis. In this paper, analyze and discuss a patient with IANE who was seen in the Children’s Hospital of Soochow University. The child started with a high fever and showed symptoms of neurological involvement within two days. The brain MRI showed bilateral symmetrical brain damage, and the diagnosis of IANE was considered in combination with relevant laboratory tests. The child was discharged after aggressive treatment but was left with mild cognitive impairment. Through a retrospective analysis of the national and international literature, it is mainly believed that early use of intravenous glucocorticoid shock combined with Oseltamivir antiviral, as well as the use of appropriate antibiotics against infection, is the best treatment regimen for IANE.
|
|
|
|
|
|
[1] Bassuk AG，Burrowes DM，McRae W. Acute necrotizing encephalopathy of childhood with radiographic progression over 10 hours [J]. Neurol，2003，60（9）：1552-1553.
[2] Levine JM，Ahsan N，Ho E，et al. Genetic Acute Necrotizing Encephalopathy Associated with RANBP2：Clinical and Therapeutic Implications in Pediatrics [J]. Mult Scler Relat Disord，2020，43：102194.
[3] Yamamoto H，Okumura A，Natsume J，et al. A severity score for acute necrotizing encephalopathy [J]. Brain Dev，2015，37（3）：322-327.
[4] Mizuguchi M，Abe J，Mikkaichi K，et al. Acute necrotising encephalopathy of childhood：a new syndrome presenting with multifocal，symmetric brain lesions [J]. J Neurol Neurosurg Psychiatry，1995，58（5）：555-561.
[5] Nakata K，Kashiwagi M，Masuda M，et al. A child with acute encephalopathy associated with quadruple viral infection [J]. Frontier pediat，2015，3：26.
[6] Mizuguchi M. Acute necrotizing encephalopathy of childhood：a novel form of acute encephalopathy prevalent in Japan and Taiwan [J]. Brain Dev，1997，19（2）：81-92.
[7] Kim JH，Kim IO，Lim MK，et al. Acute necrotizing encephalopathy in Korean infants and children：imaging findings and diverse clinical outcome [J]. Korean J Radiol，2004， 5（3）：171-177.
[8] Muhammad IH，Teh CM，Lee YL. Neurologic manifestations and complications of pandemic influenza A H1N1 in Malay- sian children：what have we learnt from the ordeal?[J]. Brain Dev，2015，37（1）：120-129.
[9] Michele DS，Peter FW. Influenza-associated acute necrotizing encephalopathy in a 2-year-old American child [J]. International Congress Series，2004，1263.
[10] Wong AM，Simon EM，Zimmerman RA，et al. Acute necrotizing encephalopathy of childhood：correlation of MR findings and clinical outcome [J]. AJNR Am J Neuroradiol，2006， 27（9）：1919-1923.
[11] 赵金芳，仇向霞，樊桂美，等.儿童急性坏死性脑病影像及临床分析[J].医学影像学杂志，2021，31（8）：1436-1439.
[12] Seo HE，Hwang SK，Choe BH，et al. Clinical spectrum and prognostic factors of acute necrotizing encephalopathy in children [J]. J Korean Med Sci，2010，25（3）：449-453.
[13] Zhu HM，Liu ZS. Advances in clinical and imaging studies of acute necrotizing encephalopathy [J]. Zhonghua Er Ke Za Zhi，2017，55（11）：865-868.
[14] Zhu HM，Zhang SM，Yao C，et al. The Clinical and Imaging Characteristics Associated With Neurological Sequelae of Pediatric Patients With Acute Necrotizing Encephalopa- thy [J]. Front Pediatr，2021，9：655074.
[15] Lee YJ，Hwang SK，Kwon S. Acute Necrotizing Encephal- opathy in Children：a Long Way to Go [J]. J Korean Med Sci，2019，34（19）：e143.
[16] Albayram S，Bilgi Z，Selcuk H，et al. Diffusion-weighted MR imaging findings of acute necrotizing encephalopathy [J]. AJNR Am J Neuroradiol，2004，25（5）：792-797.
[17] Oki J，Yoshida H，Tokumitsu A，et al. Serial neuroimages of acute necrotizing encephalopathy associated with human herpesvirus 6 infection [J]. Brain Dev，1995，17（5）：356- 359.
[18] Song Y，Li S，Xiao W，et al. Influenza-Associated Encep- halopathy and Acute Necrotizing Encephalopathy in Children：A Retrospective Single-Center Study [J]. Med Sci Monit，2021，27：e928374.
[19] Li S，Hu D，Li P，et al. Parameters Indicating Development of Influenza-Associated Acute Necrotizing Encephalopathy：Experiences from a Single Center [J]. Med Sci Monit，2021，27：e930688.
[20] Ichiyama T，Morishima T，Isumi H，et al. Analysis of cytokine levels and NF-kappaB activation in peripheral blood mononuclear cells in influenza virus-associated encephalopathy [J]. Cytokine，2004，27（1）：31-37.
[21] Siegers JY，van de Bildt M，Lin Z，et al. Viral Factors Important for Efficient Replication of Influenza A Viruses in Cells of the Central Nervous System [J]. J Virol，2019，93（11）：e02273-18.
[22] Hasegawa S，Matsushige T，Inoue H，et al. Serum and cerebrospinal fluid cytokine profile of patients with 2009 pandemic H1N1 influenza virus-associated encephalopathy [J]. Cytokine，2011，54（2）：167-172.
[23] Kawashima H，Togashi T，Yamanaka G，et al. Efficacy of plasma exchange and methylprednisolone pulse therapy on influenza-associated encephalopathy [J]. J Infect，2005，51（2）：E53-E56.
[24] Munakata M，Kato R，Yokoyama H，et al. Combined therapy with hypothermia and anticytokine agents in influenza A encephalopathy [J]. Brain Dev，2000，22（6）：373-377.
[25] Okumura A，Mizuguchi M，Aiba H，et al. Delirious behavior in children with acute necrotizing encephalopathy [J]. Brain Dev，2009，31（8）：594-599.
[26] Cho KI，Searle K，Webb M，et al. Ranbp2 haploinsufficiency mediates distinct cellular and biochemical phenotypes in brain and retinal dopaminergic and glia cells elicited by the Parkinsonian neurotoxin，1-methyl-4-phenyl-1，2，3，6-tet- rahydropyridine （MPTP）[J]. Cell Mol Life Sci，2012，69（20）：3511-3527. |
|
|
|
