Clinical study of childhood acute disseminated encephalomyelitis, multiple sclerosis, and acute transverse myelitis in Fukuoka Prefecture, Japan.
Acute disseminated encephalomyelitis (ADEM) has recently been studied in several countries owing to the development and wide spread use of imaging technology, but few epidemiological studies of childhood ADEM have been undertaken in Asian countries. To perform a comprehensive survey of ADEM and related diseases in Japanese children, we conducted a multicenter, population-based study on childhood ADEM, multiple sclerosis, and acute isolated transverse myelitis in Fukuoka Prefecture, Japan. We identified 26 children with ADEM, 8 with multiple sclerosis, and 4 with acute transverse myelitis during 5 years between September 1998 and August 2003. The incidence of childhood ADEM under the age of 15 years was 0.64 per 100,000 person-years, mean age at onset was 5.7 years, and male-female ratio was 2.3:1. The prevalence of childhood multiple sclerosis was 1.3 per 100,000 persons. The mean age at onset of multiple sclerosis, 9.3 years, was significantly higher than that of ADEM. Nineteen (73%) and four (15%) patients with ADEM experienced antecedent infectious illnesses and vaccinations, respectively, within 1 month before the onset. Clinical and radiological findings of ADEM revealed that the frequency of seizures, mean white blood cell counts in cerebrospinal fluid, and the frequency of subcortical lesions in Fukuoka study, seemed to be higher than those in previous non-Asian studies. These findings suggest that there are ethnic or geographical differences in the incidence and clinical features of ADEM, and that there might be potent genetic or environmental risk factors for ADEM distinct from those for multiple sclerosis.
Torisu
Hiroyuki
H
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. htorys@pediatr.med.kyushu-u.ac.jp
Kira
Ryutaro
R
Ishizaki
Yoshito
Y
Sanefuji
Masafumi
M
Yamaguchi
Yui
Y
Yasumoto
Sawa
S
Murakami
Yoshihiko
Y
Shimono
Masayuki
M
Nagamitsu
Shinichiro
S
Masuzaki
Mayumi
M
Amamoto
Masano
M
Kondo
Rikako
R
Uozumi
Tomohiko
T
Aibe
Miyuki
M
Gondo
Kenjiro
K
Hanai
Toshio
T
Hirose
Sinichi
S
Matsuishi
Toyojiro
T
Shirahata
Akira
A
Mitsudome
Akihisa
A
Hara
Toshiro
T
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D009188:Myelitis, Transverse / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015995:Prevalence; D012737:Sex Factors