An unusual autopsy case of cytokine storm-derived influenza-associated encephalopathy without typical histopathological findings: autopsy case report.
Cytokine storm-derived influenza-associated encephalopathy is a severe complication, affecting not only the brain but also multiple systemic organs including the heart and lungs. Hundreds of Japanese children are afflicted by influenza-associated encephalopathy every year. Influenza-associated encephalopathy can be diagnosed by pathological changes, such as advanced brain edema and disruption of astrocytic projections, which is known as clasmatodendrosis. In the present case, despite the absence of significant histopathological findings in the brain, the diagnosis of influenza-associated encephalopathy was made on the basis of autopsy findings such as brain swelling, pathological findings including diffuse alveolar damage, and increase in the concentrations of interleukin-6 in both the serum and cerebrospinal fluid. In this case, the interval from high fever to death was approximately 7 hours and may have been too short for histopathological features to develop. This is an unusual autopsy case of cytokine storm-derived influenza-associated encephalopathy without typical histopathological findings.
From the *Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, †Section of Forensic Medicine, Tokyo Medical and Dental University, ‡Department of Forensic Medicine, Tokyo Medical University, and §Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Akina
A
Nara
Hisashi
H
Nagai
Rutsuko
R
Yamaguchi
Ken-ichi
K
Yoshida
Hirotaro
H
Iwase
Masashi
M
Mizuguchi
D001927:Brain Diseases / Q000821:virology*; D001929:Brain Edema / Q000473:pathology; D002675:Child, Preschool; D006801:Humans; D009980:Influenza A virus; D007251:Influenza, Human / Q000821:virology*; D015850:Interleukin-6 / Q000097:blood* / Q000134:cerebrospinal fluid*; D008297:Male; D011654:Pulmonary Edema / Q000473:pathology
D015850:Interleukin-6