Acute necrotizing encephalopathy, a challenging diagnosis in a child with sudden neurological deterioration

Authors

DOI:

https://doi.org/10.51481/amc.v63i4.1113

Keywords:

acute febrile encephalopathy, nervous system diseases, seizures

Abstract

Acute necroziting encephalopathy (ANE) is a rare and serious entity, with significant neurological involvement, in which the radiological findings of symmetric and multifocal necroziting lesions in central nervous system are characteristic. It is an immune-mediated disease with incompletely recognized pathogenesis. We present the case of a 1 year old child, previously healthy, that presented with acute neurological deterioration after a day of fever and seizures. She required reanimation and ventilation. Typical findings of ANE were found in neuroimaging and she was treated with inmunomodulating therapy, antibiotics and antivirals. Only rhinovirus and adenovirus were isolated in respiratory sample. The patient survived with significant neurological sequelae. This is the first case of ANE published in Costa Rica.

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References

Mizuguchi M, Abe J, Mikkaichi K, Noma S, Yoshida K, Yamanaka T, et al. Acute necrotising encephalopathy of childhood: a new syndrome presenting with multifocal, symmetric brain lesions. J Neurol Neurosurg Psychiatry Res. 1995;58(5):555.

Yamamoto, H, Okumura, A, Natsume J, Kojima S, Mizuguchi M. A severity score for acute necrotizing encephalopathy. Brain Dev, 2005;37(3):322-327.

Wu X, Wu W, Pan W, Wu L, Liu K, Zhang H. Acute Necrotizing Encephalopathy: An Underrecognized Clinicoradiologic Disorder. Mediators Inflamm. 2015;(1):1-10.

Sakrani N, Almazrouei S, Mohan S, Ramsi, M. Adenovirus as a rare cause of acute necrotising encephalitis. BMJ Case Reports. 2019; 12. [posted 2019 Dec; cited 2021 Sep]: [3p.]. Available from: http://dx.doi.org/10.1136/bcr-2019-232338

Bergamino L, Capra V, Biancheri R, Rossi A, Tacchella A, Ambrosini L, et al. Immunomodulatory therapy in recurrent acute necrotizing encephalopathy ANE1: Is it useful? Brain Dev. 2012;34(5): 384-391.

Kansagra, S, Gallentine W. Cytokine Storm of Acute Necrotizing Encephalopathy. J Pediatr Neurol. 2011;45(6): 400-402.

Okumura A, Mizuguchi M, Kidokoro H, Tanaka M, Abe S, Hosoya M, et al. Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin. Brain Dev. 2009;31(3): 221-227.

Suga K, Mori K. Fatal Acute Necrotizing Encephalopathy: Clinical Presentation and Imaging Findings. J Pediatr Neurol. 2015;53(1): 93-94.

Okumura A, Abe S, Kidokoro H, Mizuguchi M. Acute necrotizing encephalopathy: A comparison between influenza and non-influenza cases. J Microbiol Immunol Infect. 2009; 53(5): 277-280.

Lim H, Ho V, Lim T, Thomas T, Chan D. Serial outcomes in acute necrotising encephalopathy of childhood: A medium and long term study. Brain Dev, 2016;38(10): 928-936.

Vargas W, Merchant S, Solomon G. Favorable Outcomes in Acute Necrotizing Encephalopathy in a Child Treated with Hypothermia. J Pediatr. 2012; 46(6): 387-389

Published

2022-04-28

How to Cite

Acute necrotizing encephalopathy, a challenging diagnosis in a child with sudden neurological deterioration. (2022). Acta Médica Costarricense , 63(4), 223-228. https://doi.org/10.51481/amc.v63i4.1113