Prognostic factors for acute encephalopathy with bright tree appearance
| Autor: | Yukihiro Kitai, Kuriko Kagitani-Shimono, Sayaka Nakano, Koji Tominaga, Shin Nabatame, Toshisaburo Nagai, Yoshiko Iwatani, Junji Azuma, Keiichi Ozono, Takeshi Okinaga, Takehisa Yamamoto |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Magnetic Resonance Spectroscopy Midazolam Encephalopathy macromolecular substances Gastroenterology Lesion chemistry.chemical_compound Epilepsy Atrophy Developmental Neuroscience Internal medicine medicine Humans Child Retrospective Studies Brain Diseases Univariate analysis Creatinine Diazepam L-Lactate Dehydrogenase medicine.diagnostic_test business.industry Brain Infant Magnetic resonance imaging Retrospective cohort study General Medicine medicine.disease Magnetic Resonance Imaging Surgery Anti-Anxiety Agents nervous system chemistry Child Preschool Acute Disease Pediatrics Perinatology and Child Health Neurology (clinical) medicine.symptom business |
| Zdroj: | Brain and Development. 37:191-199 |
| ISSN: | 0387-7604 |
| DOI: | 10.1016/j.braindev.2014.04.001 |
| Popis: | Objective: To determine the prognostic factors for encephalopathy with bright tree appearance (BTA) in the acute phase through retrospective case evaluation. Methods: We recruited 10 children with encephalopathy who presented with BTA and classified them into 2 groups. Six patients with evident regression and severe psychomotor developmental delay after encephalopathy were included in the severe group, while the remaining 4 patients with mild mental retardation were included in the mild group. We retrospectively analyzed their clinical symptoms, laboratory data, and magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings. Results: Patients in the severe group developed subsequent complications such as epilepsy and severe motor impairment. Univariate analysis revealed that higher maximum lactate dehydrogenase (LDH) levels (p = 0.055) were a weak predictor of poor outcome. Maximum creatinine levels were significantly higher (p < 0.05) and minimal platelet counts were significantly lower (p < 0.05) in the severe group than in the mild group. Acute renal failure was not observed in any patient throughout the study. MRS of the BTA lesion during the BTA period showed elevated lactate levels in 5 children in the severe group and 1 child in the mild group. MRI performed during the chronic phase revealed severe brain atrophy in all patients in the severe group. Conclusions: Higher creatinine and LDH levels and lower platelet counts in the acute phase correlated with poor prognosis. Increased lactate levels in the BTA lesion during the BTA period on MRS may predict severe physical and mental disability. |
| Databáze: | OpenAIRE |
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