tetano
Editor, Senior Moderator
Pediatr Neurol. 2014 Sep 22. pii: S0887-8994(14)00578-5. doi: 10.1016/j.pediatrneurol.2014.09.009. [Epub ahead of print]
Hypoxic-Ischemic Encephalopathy Mimicking Acute Necrotizing Encephalopathy.
Wang KY1, Singer HS2, Crain B3, Gujar S4, Lin DD5.
Author information
Abstract
BACKGROUND:
Acute necrotizing encephalopathy is a rare childhood syndrome associated with distinct and unifying neuroimaging features that are often used for the diagnosis of this entity.
PATIENT:
We describe a previously healthy 9-month-old girl who presented with upper respiratory symptoms, suspected seizures, and positive nasopharyngeal rapid antigen test for influenza A virus. Magnetic resonance imaging revealed signal abnormality in both thalami, bilateral caudate nuclei, brainstem tegmentum, subcortical white matter, and cerebellar hemispheres, suggestive of acute necrotizing encephalopathy. She subsequently had a cardiac arrest, was placed on extracorporeal membrane oxygenation, and treated with methylprednisone, intravenous immunoglobulin, and plasmapheresis without apparent clinical response. On autopsy, neuropathology indicated evidence of hypoxic-ischemic injury but lacked any evidence of hemorrhagic necrosis, which is typically associated with acute necrotizing encephalopathy.
CONCLUSION:
Combined clinical and neuroimaging features may be suggestive but not sufficient for the diagnosis of acute necrotizing encephalopathy.
Copyright ? 2014 Elsevier Inc. All rights reserved.
KEYWORDS:
acute necrotizing encephalopathy; hypoxic-ischemic encephalopathy; influenza; pediatric
PMID:
25447929
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25447929
Hypoxic-Ischemic Encephalopathy Mimicking Acute Necrotizing Encephalopathy.
Wang KY1, Singer HS2, Crain B3, Gujar S4, Lin DD5.
Author information
Abstract
BACKGROUND:
Acute necrotizing encephalopathy is a rare childhood syndrome associated with distinct and unifying neuroimaging features that are often used for the diagnosis of this entity.
PATIENT:
We describe a previously healthy 9-month-old girl who presented with upper respiratory symptoms, suspected seizures, and positive nasopharyngeal rapid antigen test for influenza A virus. Magnetic resonance imaging revealed signal abnormality in both thalami, bilateral caudate nuclei, brainstem tegmentum, subcortical white matter, and cerebellar hemispheres, suggestive of acute necrotizing encephalopathy. She subsequently had a cardiac arrest, was placed on extracorporeal membrane oxygenation, and treated with methylprednisone, intravenous immunoglobulin, and plasmapheresis without apparent clinical response. On autopsy, neuropathology indicated evidence of hypoxic-ischemic injury but lacked any evidence of hemorrhagic necrosis, which is typically associated with acute necrotizing encephalopathy.
CONCLUSION:
Combined clinical and neuroimaging features may be suggestive but not sufficient for the diagnosis of acute necrotizing encephalopathy.
Copyright ? 2014 Elsevier Inc. All rights reserved.
KEYWORDS:
acute necrotizing encephalopathy; hypoxic-ischemic encephalopathy; influenza; pediatric
PMID:
25447929
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25447929