title: Subacute sclerosing panencephalitis in pregnancy.
abstract: We present a case of subacute sclerosing panencephalitis that developed in a previously healthy 29-year-old pregnant woman who had returned from a trip to rural India shortly before the onset of symptoms. She was admitted to hospital at 27 weeks' gestation with a history of cognitive decline and difficulty completing simple tasks. She had no clinical signs of infection. The working diagnosis was autoimmune encephalitis, although extensive investigations did not lead to a final classifying diagnosis. The patient became comatose and developed hypertension, and an emergency caesarean section was done at 31 weeks to deliver the child, who seemed healthy. The patient died about 6 weeks after the onset of symptoms. The patient was found to have had subacute sclerosing panencephalitis at autopsy. In this Grand Round, we review the clinical features and treatment of subacute sclerosing panencephalitis, and the epidemiological and public health aspects of the case.
authors.affiliation: Department of Medicine, Division of Internal Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Chiu
authors.affiliation: Department of Medicine, Division of Internal Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Meatherall
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Ana
authors.initials: A
authors.lastname: Nikolic
authors.affiliation: Infection Prevention and Control Program, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Kristine
authors.initials: K
authors.lastname: Cannon
authors.affiliation: Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada; Provincial Laboratory for Public Health, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fonseca
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Joseph
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Judy
authors.initials: J
authors.lastname: MacDonald
authors.affiliation: Provincial Laboratory for Public Health, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Kanti
authors.initials: K
authors.lastname: Pabbaraju
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada; Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, AB, Canada.
authors.forename: Raymond
authors.initials: R
authors.lastname: Tellier
authors.affiliation: Provincial Laboratory for Public Health, Alberta Health Services, Calgary, AB, Canada.
authors.forename: Sallene
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada. Electronic address: mwkoch@ucalgary.ca.
authors.forename: Marcus W
authors.initials: MW
authors.lastname: Koch
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000473:pathology / Q000821:virology*; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis* / Q000473:pathology
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