Influenza-associated acute encephalopathy in Japanese children in 1994-2002
Influenza-associated acute encephalopathy in Japanese children in 1994-2002
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DOI：
10.1016/j.virusres.2004.02.016
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发表时间：
2004-07-01
期刊：
影响因子：
5
通讯作者：
Morishima, T
中科院分区：
文献类型：
--
作者：
Togashi, T;Matsuzono, Y;Morishima, T
我们讨论了日本儿童流感相关急性脑病的发病率，这与Reye综合征不同。据报道，在日本北海道的8个流感季节（1994年12月至2002年4月），89名平均年龄为3.8岁的儿童患上了这种疾病。他们都没有服用阿司匹林。大多数患者迅速昏迷，伴或不伴惊厥，从发热到中枢神经系统症状发作的平均间隔为1.7天。33例（37.1%）患者死亡，17例（19.1%）患者出现神经系统后遗症。共有53例（59.6%）病例被证实有流感病毒感染。白细胞介素-6和肿瘤坏死因子-α显着升高的血清和脑脊液样本中的两名患者谁死后迅速，暴发性过程。一个致命的情况下，尸检显示血管源性脑水肿与全身性血管病变，这表明高度活化的细胞因子引起的血管内皮细胞的全身性损伤在这种疾病的病理生理学中起着核心作用。我们的结论是，流感相关的急性脑病可能是一个被低估的综合征，是另一个原因，以促进疫苗接种流感的婴儿和幼儿。(C)2004 Elsevier B. V.保留所有权利。
We addressed the incidence of influenza-associated acute encephalopathy, which is distinct from Reye syndrome, in children in Japan. Eighty-nine children with a mean age of 3.8 years were reported to have developed this disease during eight influenza seasons (December 1994-April 2002) in Hokkaido, Japan. None of them had received aspirin. Most of the patients rapidly became comatose with or without convulsions with a mean interval of 1.7 days from the onset of fever to the onset of central nervous system symptoms. Thirty-three (37.1%) patients died and 17 (19.1%) patients had neurological sequelae. A total of 53 (59.6%) cases were proved to have an influenza virus infection. Interieukin-6 and tumor necrosis factor-alpha were markedly elevated in serum and cerebrospinal fluid samples from two patients who died after a rapid, fulminant course. A post-mortem examination of one fatal case revealed vasogenic brain edema with generalized vasculopathy, suggesting that the generalized impairment of vascular endothelial cells caused by highly activated cytokines plays a central role in the pathophysiology of this disease. We conclude that influenza-associated acute encephalopathy may be an underestimated syndrome and is another reason to promote vaccination against influenza in infants and younger children. (C) 2004 Elsevier B.V. All rights reserved.