[Treatment of influenza-associated encephalopathy].
Recently, the number of reports of encephalopathy associated with influenza has increased in Japan. The abrupt onset of seizure and coma after development of high-grade fever is a prominent indicator of CNS involvement. Approximately 600 patients have been reported during 1999-2002. 78% of them are younger than 6 yr old, and the mortality was 30% in 1999 and 2000 seasons. The pathogenicity of brain dysfunction is still unknown. However, elevation of cytokines(TNF-alpha and IL-6) and the damage of vascular endothelial cells were demonstrated. Thus, the prognosis of this illness was extremely poor. Intensive care trial in combination with (1) anti-virals, (2) high dose gamma-grobulin, (3) steroid pulse therapy. (4) high dose AT III, (5) head cooling and (6) plasma exchange has started since 2001, that could reduce the mortality from 30 to 15% in 2001 and 02. In order to establish more effective treatment, further investigation will be necessary.
Morishima
Tsuneo
T
Department of Pediatrics, Okayama University School of Medicine.
D000990:Antithrombin III / Q000008:administration & dosage; D000998:Antiviral Agents / Q000627:therapeutic use*; D017209:Apoptosis; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002199:Capillary Permeability; D018792:Encephalitis, Viral / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004730:Endothelium, Vascular / Q000473:pathology; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007251:Influenza, Human / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D015850:Interleukin-6 / Q000378:metabolism; D008775:Methylprednisolone / Q000008:administration & dosage; D010951:Plasma Exchange; D011379:Prognosis; D020551:Pulse Therapy, Drug; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D005719:gamma-Globulins / Q000008:administration & dosage*
D000998:Antiviral Agents; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D005719:gamma-Globulins; D000990:Antithrombin III; D008775:Methylprednisolone