tetano
Editor, Senior Moderator
Brain Dev. 2017 Aug 8. pii: S0387-7604(17)30211-5. doi: 10.1016/j.braindev.2017.07.014. [Epub ahead of print]
[h=1]Cause of acute encephalitis/encephalopathy in Japanese children diagnosed by a rapid and comprehensive virological detection system and differences in their clinical presentations.[/h] Takasawa K[SUP]1[/SUP], Nakagawa R[SUP]2[/SUP], Takishima S[SUP]3[/SUP], Moriyama K[SUP]4[/SUP], Watanabe K[SUP]5[/SUP], Kiyohara K[SUP]6[/SUP], Hasegawa T[SUP]3[/SUP], Shimohira M[SUP]7[/SUP], Kashimada K[SUP]4[/SUP], Shimizu N[SUP]5[/SUP], Morio T[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Acute encephalitis/encephalopathy (AE/E) is a rare and severe complication of common childhood infections; however, a treatment strategy based on clinical and pathological evidence has not been established.
[h=4]METHODS:[/h] The clinical data and aetiological results using a rapid and comprehensive virological detection system of 62 Japanese children diagnosed with AE/E from 2010 to 2014 were collected. We assessed clinical differences between causes and effectiveness of our multiplex PCR system to establish a pathogen-based treatment strategy for AE/E.
[h=4]RESULTS:[/h] Suspected causes were detected in 84% of patients, and our multiplex PCR system contributed to diagnosing 38% of the patients. Furthermore, a negative virus PCR might be important for inferring underlying disease. Most cases were triggered by human herpes virus (HHV) 6/7 (32%) and influenza virus (24%). The causes of AE/E depended on age (p=0.00089) but not on sex (p=0.94). The median age of HHV6/7-associated AE/E was 2.3years, which is lower than the median ages of AE/E associated with other viruses. Major initial treatments were pulse steroid therapy (83.9%) and acyclovir (71%). Most of the patients in this study had good prognoses: 77% recovered without neurological sequalae.
[h=4]CONCLUSIONS:[/h] Our virological detection system was useful for detecting the cause of AE/E, and may also contribute to construction of pathogen-based treatment strategies for AE/E. Our data indicated the possibility that early intervention with pulse steroid therapy could be effective for treating AE/E. Further investigation for selection of antiepileptic drugs and additional therapies might be required to prevent progression of AE/E.
Copyright ? 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] Encephalitis; Encephalopathy; HHV6; Virus PCR
PMID: 28801087 DOI: 10.1016/j.braindev.2017.07.014
[h=1]Cause of acute encephalitis/encephalopathy in Japanese children diagnosed by a rapid and comprehensive virological detection system and differences in their clinical presentations.[/h] Takasawa K[SUP]1[/SUP], Nakagawa R[SUP]2[/SUP], Takishima S[SUP]3[/SUP], Moriyama K[SUP]4[/SUP], Watanabe K[SUP]5[/SUP], Kiyohara K[SUP]6[/SUP], Hasegawa T[SUP]3[/SUP], Shimohira M[SUP]7[/SUP], Kashimada K[SUP]4[/SUP], Shimizu N[SUP]5[/SUP], Morio T[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Acute encephalitis/encephalopathy (AE/E) is a rare and severe complication of common childhood infections; however, a treatment strategy based on clinical and pathological evidence has not been established.
[h=4]METHODS:[/h] The clinical data and aetiological results using a rapid and comprehensive virological detection system of 62 Japanese children diagnosed with AE/E from 2010 to 2014 were collected. We assessed clinical differences between causes and effectiveness of our multiplex PCR system to establish a pathogen-based treatment strategy for AE/E.
[h=4]RESULTS:[/h] Suspected causes were detected in 84% of patients, and our multiplex PCR system contributed to diagnosing 38% of the patients. Furthermore, a negative virus PCR might be important for inferring underlying disease. Most cases were triggered by human herpes virus (HHV) 6/7 (32%) and influenza virus (24%). The causes of AE/E depended on age (p=0.00089) but not on sex (p=0.94). The median age of HHV6/7-associated AE/E was 2.3years, which is lower than the median ages of AE/E associated with other viruses. Major initial treatments were pulse steroid therapy (83.9%) and acyclovir (71%). Most of the patients in this study had good prognoses: 77% recovered without neurological sequalae.
[h=4]CONCLUSIONS:[/h] Our virological detection system was useful for detecting the cause of AE/E, and may also contribute to construction of pathogen-based treatment strategies for AE/E. Our data indicated the possibility that early intervention with pulse steroid therapy could be effective for treating AE/E. Further investigation for selection of antiepileptic drugs and additional therapies might be required to prevent progression of AE/E.
Copyright ? 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] Encephalitis; Encephalopathy; HHV6; Virus PCR
PMID: 28801087 DOI: 10.1016/j.braindev.2017.07.014