title: Cytotoxic edema and interleukin-6 in hypertensive encephalopathy.
abstract: We report a female, 10 years of age, with juvenile rheumatoid arthritis accompanied by hypertensive encephalopathy. The patient developed a cytotoxic brain lesion, as revealed by the high signal intensity on diffusion-weighted magnetic resonance imaging, which corresponded to the hypoperfusion area on single-photon emission computed tomography scan using (99m)Tc-ethylcysteinatedimer. Cerebrospinal fluid interleukin-6 activity was elevated when the hypertensive encephalopathy revealed active central nervous system disease, and its activity decreased when the encephalopathy recovered from the central nervous system manifestations. We speculated that the cytotoxic edema and associated parenchymal damage in hypertensive encephalopathy were closely related to the intrathecal overproduction of interleukin-6.
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga 520-2192, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Takano
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohno
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Mandai
authors.forename: Shinobu
authors.initials: S
authors.lastname: Yoshida
mesh_terms: D001921:Brain / Q000098:blood supply / Q000473:pathology; D001929:Brain Edema / Q000134:cerebrospinal fluid* / Q000150:complications* / Q000175:diagnosis; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D005260:Female; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000150:complications*; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007375:Interleukin-1 / Q000134:cerebrospinal fluid; D015850:Interleukin-6 / Q000134:cerebrospinal fluid*; D008279:Magnetic Resonance Imaging; D015899:Tomography, Emission-Computed, Single-Photon; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid
chemical_list: D007074:Immunoglobulin G; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha