title: Efficacy of plasma exchange and methylprednisolone pulse therapy on influenza-associated encephalopathy.
abstract: Patients with a new type of influenza-associated encephalopathy with high mortality are increasing in Japan and the United States. We present three patients treated with methyprednisolone pulse treatment and plasma exchange to remove cytokines, and all three patients recovered without severe sequela. IL-6 decreased dramatically after the start of the plasma exchange and methyprednisolone. Therefore when influenza-associated encephalopathy is actually diagnosed, steroid pulse therapy should be started at an early stage, and when signs of DIC and/or MOF appear, plasma exchange is recommended to remove the cytokines and NOx.
authors.affiliation: Department of Paediatrics, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. hisashi@tokyo-med.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Takehiro
authors.initials: T
authors.lastname: Togashi
authors.forename: Gaku
authors.initials: G
authors.lastname: Yamanaka
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakajima
authors.forename: Makoto
authors.initials: M
authors.lastname: Nagai
authors.forename: Kentarou
authors.initials: K
authors.lastname: Aritaki
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: Kouji
authors.initials: K
authors.lastname: Takekuma
authors.forename: Akinori
authors.initials: A
authors.lastname: Hoshika
mesh_terms: D001927:Brain Diseases / Q000628:therapy* / Q000821:virology*; D002675:Child, Preschool; D016207:Cytokines / Q000032:analysis; D006801:Humans; D007251:Influenza, Human / Q000150:complications*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D010951:Plasma Exchange; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D018696:Neuroprotective Agents; D008775:Methylprednisolone