title: Diagnostic and prognostic factors for acute encephalopathy.
abstract: BACKGROUND
  Acute encephalopathy has the possibility of sequelae. While early treatment is required to prevent the development of sequelae, differential diagnosis is of the utmost priority. The aim of this study was therefore to identify parameters that can facilitate early diagnosis and prediction of outcome of acute encephalopathy.
  
  
  METHODS
  We reviewed the medical charts of inpatients from 2005 to 2011 and identified 33 patients with febrile status epilepticus. Subjects were classified into an acute encephalopathy group (n = 20) and a febrile convulsion group (n = 13), and the parameters serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), ammonia (NH3), cerebrospinal fluid (CSF) tau protein, and CSF interleukin-6 compared between them. Furthermore, the relationship between each parameter and prognosis was investigated in the encephalopathy group.
  
  
  RESULTS
  Significant differences in serum AST, ALT, and LDH were observed between the febrile convulsion and acute encephalopathy group. Moreover, a significant difference in serum LDH was noted between the patients with and without developmental regression at the time of hospital discharge in the encephalopathy group. In particular, CSF tau protein was found to be highly likely to indicate progress, with CSF tau protein >1000 pg/dL associated with poor prognosis leading to developmental regression.
  
  
  CONCLUSIONS
  Serum AST, ALT and LDH may be related to early diagnosis and prognosis, and should be carefully investigated in patients with encephalopathy. CSF tau protein could also be used as an indicator of poor prognosis in acute encephalopathy.
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Motojima
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Nagura
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Asano
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arakawa
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Eiko
authors.initials: E
authors.lastname: Takada
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sakurai
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Moriwaki
authors.affiliation: Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D000208:Acute Disease; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D001927:Brain Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D003294:Seizures, Febrile / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016875:tau Proteins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: acute encephalopathy; diagnosis; pediatrics; prognosis; tau protein