BMJ Case Rep . Neuro-ophthalmological consequences of acute influenza A encephalitis in a genetically predisposed child

[tetano]

BMJ Case Rep


. 2020 Sep 14;13(9):e235636.
doi: 10.1136/bcr-2020-235636.
Neuro-ophthalmological consequences of acute influenza A encephalitis in a genetically predisposed child


Catarina Xavier ¹ , Miguel Boncquet Vieira ¹ , Cristina Ferreira ^{1 2 3} , Joana Tavares Ferreira ^{4 3 5}



Affiliations

• PMID: 32928829
• DOI: 10.1136/bcr-2020-235636

Abstract

Acute necrotising encephalopathy (ANE) is a rare disease that corresponds to a rapidly progressive encephalopathy induced by a viral infection. It is frequently associated with a mutation on the RAN-binding protein 2 (RANBP2) gene-ANE1. We present a case of a 5-year-old boy with a clinical picture of influenza aggravated to an acute encephalopathy picture after the 3rd day. Complementary examinations came back positive for the influenza A virus, and MRI showed aspects compatible with ANE. He was treated accordingly with subsequent improvement of the clinical picture. During ambulatory follow-up, a mutation was detected on the RANBP2 gene and, at the ophthalmological level, bilateral peripheral constriction on the campimetry and a significant reduction of bilateral peripapillary retinal nerve fibre layer was reported. Our case contributes to the enrichment of the neuro-ophthalmological literature and expands the spectrum of sequelae of this rare entity in the Caucasian population.

Keywords: infection (neurology); neuroopthalmology; visual pathway.