Table 1.
Clinical characteristics of 41 pediatric patients with ANE.
| Patients | |
|---|---|
| (n = 41) | |
| Age, median (IQR) (m) | 53.99 (8.9–142) |
| ≤48 | 24 (59%) |
| >48 | 17 (41%) |
| Sex | |
| Male | 23 (56%) |
| Female | 18 (44%) |
| Morbidity season | |
| Winter–Spring (December–May) | 23 (56%) |
| Summer–Autumn (June–November) | 18 (44%) |
| Symptoms of prodromal infection | |
| Fever | 41 (100%) |
| Respiratory symptoms | 19 (46%) |
| Digestive symptoms | 20 (49%) |
| Other symptoms (rash, fatigue, headache, dizziness) | 7 (17%) |
| Etiology | |
| Influenza virus infection | 8 (20%) |
| Other etiological infections (Mycoplasma pneumoniae, Epstein–Barr virus, cytomegalovirus, human bocavirus) | 17 (41%) |
| No clear etiological infection | 16 (39%) |
| Intervals from prodromal infection to acute encephalopathy (d) | |
| 1 | 13 (32%) |
| 2 | 16 (39%) |
| 3 | 8 (20%) |
| 4 | 3 (7%) |
| 5 | 1 (2%) |
| Presentation of acute encephalopathy | |
| Seizures with status epilepticus | 7 (17%) |
| Seizures without status epilepticus | 25 (61%) |
| No seizures | 9 (22%) |
| Lethargy | 4 (10%) |
| Stupor | 5 (12%) |
| Mild coma | 19 (46%) |
| Deep coma | 13 (32%) |
| MODS | 27 (66%) |
| Shock | 4 (10%) |
| DIC | 5 (12%) |
| Laboratory findings | |
| PLT <100 × 109/L | 3 (7%) |
| ALT > 50 U/L | 25 (61%) |
| AST > 50 U/L | 32 (78%) |
| LDH > 300 U/L | 31 (76%) |
| CK > 170 U/L | 30 (73%) |
| APTT > 39 s | 17 (41%) |
| CSF protein > 60 mg/dl | 24 (59%) |
| Location of lesions | |
| Thalamus | 41 (100.00%) |
| Periventricular | 34 (83%) |
| Basal ganglia | 26 (63%) |
| Brainstem | 31 (76%) |
| Cerebral cortex and subcortex | 20 (49%) |
| Cerebellum | 18 (44%) |
| Radiological findings on follow-Up MRIa | |
| Hemorrhage | 28/34 (82%) |
| Cavitation | 28/34 (82%) |
| Atrophy | 21/34 (62%) |
| Therapy | |
| Methylprednisolone pulse | 41 (100%) |
| IVIG | 38 (93%) |
| Hypothermia | 24 (59%) |
| Plasma exchange | 0 (0%) |
| Admission to ICU | 28 (68%) |
| Endotracheal intubation | 9 (22%) |
| Prognosis | |
| Death | 7 (17%) |
| Survival | 34 (83%) |
| Mild sequelae | 8/34 (24%)a |
| Moderate sequelae | 12/34 (35%)a |
| Severe sequelae | 14/34 (41%)a |
m, month; d, day; IQR, interquartile range; MODS, multiple organ dysfunction syndrome; DIC, disseminated intravascular coagulation; ICU, intensive care unit; PLT, Platelet count; ALT, alanine aminotransferase; AST, aspartate transaminase; LDH, lactase dehydrogenase; CK, creatine kinase; APTT, activated partial thromboplastin time; CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; IVIG, intravenous immune globulin.
a
Data in 34 survivors.