Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August-December 2015.
Clinical Features of Acute Flaccid Myelitis Temporally Associated With an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August-December 2015.
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DOI：
10.1093/cid/cix860
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发表时间：
2018-02-10
期刊：
影响因子：
--
通讯作者：
Acute Flaccid Myelitis Collaborative Study Investigators
中科院分区：
文献类型：
--
作者：
Chong PF;Kira R;Mori H;Okumura A;Torisu H;Yasumoto S;Shimizu H;Fujimoto T;Hanaoka N;Kusunoki S;Takahashi T;Oishi K;Tanaka-Taya K;Acute Flaccid Myelitis Collaborative Study Investigators
全国报告了 59 例急性弛缓性脊髓炎病例，与 2015 年 8 月至 12 月肠道病毒 D68 (EV-D68) 爆发同时发生。人们注意到了很强的时间关联性，并从一些脑脊液和血液标本中检测到了 EV-D68。在一些患者中鉴定出抗神经节苷脂抗体，并分析了预后因素。急性弛缓性脊髓炎（AFM）是一种急性弛缓性麻痹综合征，累及脊髓运动神经元，病因不明。我们调查了 2015 年秋季日本肠道病毒 D68 (EV-D68) 爆发同时发生的 AFM 簇的特征和预后因素。在 2015 年 8 月至 12 月的全国范围内调查后进行了 AFM 病例系列研究。对放射学和神经生理学数据进行了集中审查，并对现有标本进行了病毒学研究。已确定 59 例 AFM 病例（58 例确诊，1 例疑似），其中包括 55 名儿童和 4 名成人（中位年龄 4.4 岁）。 AFM 流行曲线显示与病原体监测中的 EV-D68 检测有很强的时间相关性，但与其他病原体没有相关性。在 9 例患者中检测到 EV-D68：5 例在鼻咽部，2 例在粪便中，1 例在脑脊液（成人病例）中，1 例在气管抽吸、鼻咽和血清样本中（之前使用类固醇的儿科病例）。病例表现出从 1 肢到 4 肢受累的不同程度的麻痹模式，但所有确诊病例在磁共振成像上均出现纵向脊髓灰质病变（中位，20 个脊髓节段）。 59 例中有 50 例 (85%) 观察到脑脊液细胞增多，29 例中有 8 例 (28%) 抗神经节苷脂抗体呈阳性，这在格林-巴利综合征中经常观察到。 52 名患者在随访时表现出不同程度的残余无力。良好的预后因素包括治疗前徒手肌肉力量测试单位评分 >3、正常的 F 波持续性和 EV-D68 阴性状态。 EV-D68可能是AFM的致病因子之一，而免疫反应等宿主易感因素可能有助于AFM的发展。
Fifty-nine acute flaccid myelitis cases were reported nationwide, coincident with enterovirus D68 (EV-D68) outbreak from August to December 2015. Strong temporal association was noted, and EV-D68 was detected from some cerebrospinal fluid and blood specimens. Antiganglioside antibodies were identified in some patients, and prognostic factors were analyzed. Acute flaccid myelitis (AFM) is an acute flaccid paralysis syndrome with spinal motor neuron involvement of unknown etiology. We investigated the characteristics and prognostic factors of AFM clusters coincident with an enterovirus D68 (EV-D68) outbreak in Japan during autumn 2015. An AFM case series study was conducted following a nationwide survey from August to December 2015. Radiographic and neurophysiologic data were subjected to centralized review, and virology studies were conducted for available specimens. Fifty-nine AFM cases (58 definite, 1 probable) were identified, including 55 children and 4 adults (median age, 4.4 years). The AFM epidemic curve showed strong temporal correlation with EV-D68 detection from pathogen surveillance, but not with other pathogens. EV-D68 was detected in 9 patients: 5 in nasopharyngeal, 2 in stool, 1 in cerebrospinal fluid (adult case), and 1 in tracheal aspiration, nasopharyngeal, and serum samples (a pediatric case with preceding steroid usage). Cases exhibited heterogeneous paralysis patterns from 1- to 4-limb involvement, but all definite cases had longitudinal spinal gray matter lesions on magnetic resonance imaging (median, 20 spinal segments). Cerebrospinal fluid pleocytosis was observed in 50 of 59 cases (85%), and 8 of 29 (28%) were positive for antiganglioside antibodies, as frequently observed in Guillain-Barré syndrome. Fifty-two patients showed variable residual weakness at follow-up. Good prognostic factors included a pretreatment manual muscle strength test unit score >3, normal F-wave persistence, and EV-D68–negative status. EV-D68 may be one of the causative agents for AFM, while host susceptibility factors such as immune response could contribute to AFM development.
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急性弛缓性脊髓炎儿童肠道病毒 D68 感染，美国科罗拉多州，2014 年。
影响因子：
11.8
作者：
Aliabadi N;Messacar K;Pastula DM;Robinson CC;Leshem E;Sejvar JJ;Nix WA;Oberste MS;Feikin DR;Dominguez SR
通讯作者：
Dominguez SR
DOI：
10.1302/0301-620x.89b2.18348
发表时间：
2007-02-01
影响因子：
--
作者：
Funahashi, S.;Nagano, A.;Omura, T.
通讯作者：
Omura, T.
影响因子：
3.4
作者：
Kusunoki, S;Morita, D;Kanazawa, I
通讯作者：
Kanazawa, I
影响因子：
11.8
作者：
Horner LM;Poulter MD;Brenton JN;Turner RB
通讯作者：
Turner RB
影响因子：
3.8
作者：
Nelson, Gary R.;Bonkowsky, Joshua L.;Bale, James F., Jr.
通讯作者：
Bale, James F., Jr.