Acute Disseminated Encephalomyelitis with Seizures and Myocarditis: A Fatal Triad
| Autor: | C. Hauenstein, Astrid Bertsche, Axel Petzold, Fred Zack, Hanne Lademann, Daniel A. Reuter, Christian Spang, Jan Däbritz, Erik Bahn, Philipp Warnke, Andreas Büttner, Johannes Ehler |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Myocarditis Fulminant Case Report 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine delirium Human metapneumovirus Medicine critical illness lcsh:R5-920 critical ill patient biology business.industry ADEM Cardiogenic shock General Medicine medicine.disease biology.organism_classification 3. Good health Upper respiratory tract infection Acute disseminated encephalomyelitis Epileptic seizure Headaches medicine.symptom lcsh:Medicine (General) business 030217 neurology & neurosurgery |
| Zdroj: | Medicina Medicina, Vol 56, Iss 277, p 277 (2020) |
| ISSN: | 1648-9144 1010-660X |
| Popis: | Autoimmune pathology of acute disseminated encephalomyelitis (ADEM) is generally restricted to the brain. Our objective is to expand the phenotype of ADEM. A four-year-old girl was admitted to the pediatric emergency room of a university medical center five days after a common upper respiratory tract infection. Acute symptoms were fever, leg pain, and headaches. She developed meningeal signs, and her level of consciousness dropped rapidly. Epileptic seizure activity started, and she became comatose, requiring intubation and mechanical ventilation. Serial brain magnetic resonance imaging (MRI) illustrated the fulminant development of ADEM. Treatment escalation with high-dose corticosteroids, immunoglobulins, and plasma exchange did not lead to clinical improvement. On day ten, the patient developed treatment-refractory cardiogenic shock and passed away. The postmortem assessment confirmed ADEM and revealed acute lymphocytic myocarditis, likely explaining the acute cardiac failure. Human metapneumovirus and picornavirus were detected in the tracheal secrete by PCR. Data sources–medical chart of the patient. This case is consistent with evidence from experimental findings of an association of ADEM with myocarditis as a postinfectious systemic autoimmune response, with life-threatening involvement of the brain and heart. |
| Databáze: | OpenAIRE |
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