Neurological complications of pandemic influenza (H1N1) in children
Neurological complications of pandemic influenza (H1N1) in children
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DOI：
10.1007/s00431-010-1352-y
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发表时间：
2011-06-01
影响因子：
3.6
通讯作者：
Ciftci, Ergin
中科院分区：
文献类型：
--
作者：
Yildizdas, Dincer;Kendirli, Tanil;Ciftci, Ergin
本研究的目的是确定表现出大流行性流感（H1N1）神经系统并发症的儿童的临床特征。我们回顾了所有因神经系统症状住院并经鼻咽拭子逆转录聚合酶链反应证实感染流感病毒的儿童的医疗和实验室记录。8名年龄在10个月至7岁之间的儿童因大流行性流感（H1N1）出现神经系统并发症，其中5名是女性。其中四人以前是健康的；慢性肾功能衰竭（CRF） 1例，神经系统疾病3例。其中7人癫痫发作，意识改变。其中7人在儿科重症监护病房接受了随访。我们对4例患者进行了腰椎穿刺，脑脊液检查显示1例多细胞增生，3例无细胞。4例患者行神经影像学检查，其中3例出现异常。我们诊断无菌性脑膜炎1例，急性播散性脑脊髓炎（ADEM） 1例，急性坏死性脑病（ANE） 1例，脑膜脑炎1例，癫痫持续状态4例。所有患者均给予奥司他韦和抗癫痫药物治疗。1例CRF患者死亡；4名先前健康的患者完全康复，3名患有神经系统疾病的患者恢复到以前的神经系统状态。总之，在大流行性流感（H1N1）感染期间，除了呼吸道感染外，还可能出现神经系统并发症。神经系统受累的类型可能是可变的，如引发癫痫发作、无菌性脑膜炎、脑炎、ADEM和ANE。神经系统并发症经常完全恢复，特别是在以前健康的儿童中，但有时会发生严重的临床病程。
The aim of this study was to determine the clinical characteristics of children demonstrating neurological complications with pandemic influenza (H1N1). We reviewed the medical and laboratory records of all children who were hospitalized with neurological symptoms and who had proven influenza virus infection by reverse transcriptase-polymerase chain reaction on nasal and throat swabs. Eight children aged between 10 months and 7 years had neurological complications due to pandemic influenza (H1N1) and five of them were female. Four of them were previously healthy; there was chronic renal failure (CRF) in one and neurologic disease in three patients. Seven of them had seizure and altered consciousness. Seven of them were followed in pediatric intensive care units. We performed lumbar puncture in four patients and their cerebrospinal fluid examinations showed pleocytosis in one and no cell in three specimens. Neuroimaging was performed in four patients and three of them had abnormalities. We diagnosed aseptic meningitis in one, acute disseminated encephalomyelitis (ADEM) in one, acute necrotizing encephalopathy (ANE) in one, meningoencephalitis in one, and status epilepticus in four patients. All patients were treated with oseltamivir and antiepileptic drugs. One patient with CRF died; four previously healthy patients recovered fully, and three patients who had neurologic disorder returned to their previous neurological status. In conclusion, during pandemic influenza (H1N1) infection, neurological complications may be seen in addition to the respiratory infection. The type of neurological involvement may be variable such as triggering seizure, aseptic meningitis, encephalitis, ADEM, and ANE. Neurological complications frequently recover fully especially in previously healthy children, but sometimes a severe clinical course occurs.