Parameters Indicating Development of Influenza-Associated Acute Necrotizing Encephalopathy: Experiences from a Single Center

作者：Suyun Li, Dandan Hu, Peiqing Li, Weiqiang Xiao, Huixian Li, Guang‐Ming Liu, Yongling Song, Shuyao Ning, Qiuyan Peng, Danyang Zhao, Minxiong Situ, Wanqi Li, Peiqun Wu, Jipeng Zheng, Yueting Liu, Lin Hu, Pengfei Wang, Zhengbin Hu, Wencheng Ma, Jun Shen, Sida Yang · 发表于：Medical Science Monitor · 年份：2021 · DOI：10.12659/msm.930688 · 被引用次数：11 · 研究领域：Infectious Encephalopathies and Encephalitis、Influenza Virus Research Studies、Bacterial Infections and Vaccines

BACKGROUND Influenza-associated acute necrotizing encephalopathy (IANE) can be lethal and disabling and have a sudden onset and deteriorate rapidly but lacks early diagnostic indicators. We aimed to examine the early clinical diagnostic indicators in children with IANE. MATERIAL AND METHODS Acute influenza patients were grouped according to their clinical manifestations: flu alone (FA), flu with febrile seizure (FS), influenza-associated encephalopathy (IAE), and IANE. The clinical features, biomarkers, neuroelectrophysiological results, and neuroimaging examination results were compared. RESULTS A total of 31 patients were included (FA (n=4), FS (n=8), IAE (n=14), and IANE (n=5)). The IANE group, whose mean age was 3.7 years, was more likely to show rapid-onset seizure, acute disturbance of consciousness (ADOC), Babinski's sign, and death/sequela. More patients in the IANE group required tracheal intubation mechanical ventilation and received intravenous immunoglobulins (IVIG) and glucocorticoids. The alanine aminotransferase (ALT), aspartate transaminase (AST), and lactate dehydrogenase (LDH) levels in the IANE group were significantly higher than in the FS and IAE groups. The aquaporin-4 (AQP-4) antibody and malondialdehyde (MDA) levels in the serum and cerebrospinal fluid (CSF) were notably higher in IANE patients in the acute stage compared with FS and IAE patients. All patients in the IANE group had positive neuroimaging findings. CONCLUSIONS Early clinical warning fact...