Acute encephalopathy and encephalitis caused by influenza virus infection
Acute encephalopathy and encephalitis caused by influenza virus infection
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流感病毒感染引起的急性脑病和脑炎
DOI：
10.1097/wco.0b013e328338f6c9
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发表时间：
2010-06-01
影响因子：
4.8
通讯作者：
Li, Kangsheng
中科院分区：
文献类型：
--
作者：
Wang, Gefei F.;Li, Weizhong;Li, Kangsheng
目的流感相关的急性脑病/脑炎(IAE)是一种罕见但严重的并发症，具有很高的死亡率和神经后遗症。该综述讨论了IAE研究的最新进展，以更好地了解该病的特征、人群、结果、诊断和发病机制。近年来，许多国家报告了许多IAE病例，包括日本、加拿大、澳大利亚、奥地利、荷兰、美国、瑞典等国家和地区。在新的甲型H1N1流感大流行期间，报告了许多甲型H1N1流感感染儿童的IAE病例，特别是那些因流感感染而住院的儿童。IAE的发病机制尚不完全清楚，但可能涉及病毒对中枢神经系统的入侵、促炎细胞因子、代谢紊乱或遗传易感性。一种常染色体显性遗传性病毒性急性坏死性脑病(ANE)最近被发现存在RANBP2基因的错义突变。另一例A型流感感染后复发的A型流感病例也被报告在一个带有RANBP2突变的遗传易感家庭中。虽然IAE并不常见，但与流感感染的高发病率相比，它是严重的。然而，卫生从业者并没有充分认识到这种并发症。最近的进展突出了这种并发症的威胁，这将有助于我们更好地了解IAE。
Purpose of reviewInfluenza-associated acute encephalopathy/encephalitis (IAE) is an uncommon but serious complication with high mortality and neurological sequelae. This review discusses recent progress in IAE research for a better understanding of the disease features, populations, outcomes, diagnosis, and pathogenesis. Recent findingsIn recent years, many IAE cases were reported from many countries, including Japan, Canada, Australia, Austria, the Netherlands, United States, Sweden, and other countries and regions. During the novel influenza A/H1N1 pandemic, many IAE cases with A/H1N1 infection in children were reported, particularly in those hospitalized with influenza infection. Pathogenesis of IAE is not fully understood but may involve viral invasion of the CNS, proinflammatory cytokines, metabolic disorders, or genetic susceptibility. An autosomal dominant viral acute necrotizing encephalopathy (ANE) was recently found to have missense mutations in the gene Ran-binding 2 (RANBP2). Another recurrent ANE case following influenza A infection was also reported in a genetically predisposed family with an RANBP2 mutation. SummaryAlthough IAE is uncommon, compared with the high incidence of influenza infection, it is severe. However, this complication is not duly recognized by health practitioners. Recent advances highlight the threat of this complication, which will help us to have a better understanding of IAE.