[Elderly autopsy case of influenza-associated encephalopathy].
[Elderly autopsy case of influenza-associated encephalopathy].
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老年流感相关脑病尸检一例[J].
DOI：
10.5692/clinicalneurol.48.713
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
N. Kohara
中科院分区：
文献类型：
--
作者：
H. Yoshimura;Y. Imai;M. Beppu;N. Ohara;J. Kobayashi;A. Kuzuya;H. Yamagami;M. Kawamoto;N. Kohara
流感相关脑病（IAE）通常发生在5岁以下的儿童中。成人IAE病例非常罕见，迄今为止，还没有明确的成人尸检病例报告。在这里，我们提出了第一个明确的成人尸检案件的IAE。一位76岁的男性在感染A型流感病毒引起发热一天后突然昏迷。入院后不久，他的病情并发DIC、休克和多器官衰竭，并被诊断为IAE。进行了奥司他韦给药和类固醇脉冲治疗，但这些被证明是无效的。患者在脑病发作后约24小时死亡。尸检发现大量脑水肿和弥漫性变形胶质细胞增加，无炎性细胞浸润。从他的肺部分离出甲型流感/香港病毒（H3）。血清IL-6水平极高（35，800 pg/ml;正常，0.221-4.62 pg/ml）。这个成人病例的临床过程、实验室和病理结果与典型的儿童期发病的IAE相似，提示相同的发病机制。在流感季节，IAE应考虑到成人患者的精神状态改变和发热的鉴别诊断。
Influenza-associated encephalopathy (IAE) usually occurs in children aged <5 years. Adult cases of IAE are very rare and, thus far, no definite adult autopsy case has been reported. Here, we present the first definite adult autopsy case of IAE. A 76-year-old man presented with sudden coma a day after the onset of fever caused by infection with influenza type A virus. Soon after admission, his condition was complicated by DIC, shock, and multiple organ failure, and he was diagnosed with IAE. Oseltamivir administration and steroid pulse therapy were performed but these proved to be ineffective. The patient died about 24 hours after the onset of encephalopathy. The autopsy revealed massive brain edema and diffuse increase of amoeboid glias without inflammatory cell infiltration. Influenza type A/Hong Kong virus (H3) was isolated from his lungs. Serum IL-6 level was extremely high (35,800 pg/ml; normal, 0.221-4.62 pg/ml). The clinical course, and the laboratory and pathological findings of this adult case resembled those of a typical childhood-onset IAE, suggesting the same pathogenesis. During the influenza season, IAE should be taken into account for differential diagnosis in adult patients with altered mental status and fever.
影响因子：
1.4
作者：
Takahashi, M;Yamada, T;Toyoda, T
通讯作者：
Toyoda, T