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Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study

BACKGROUND: Although influenza primarily affects the respiratory system, it can cause severe neurological complications, especially in younger children, but knowledge about the early indicators of acute necrotizing encephalopathy (ANE) is limited. The main purpose of this article is to summarize the...

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Autores principales: Song, Yongling, Li, Suyun, Xiao, Weiqiang, Shen, Jun, Ma, Wencheng, Wang, Qiang, Yang, Haomei, Liu, Guangming, Hong, Yan, Li, Peiqing, Yang, Sida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789050/
https://www.ncbi.nlm.nih.gov/pubmed/33388740
http://dx.doi.org/10.12659/MSM.928374
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author Song, Yongling
Li, Suyun
Xiao, Weiqiang
Shen, Jun
Ma, Wencheng
Wang, Qiang
Yang, Haomei
Liu, Guangming
Hong, Yan
Li, Peiqing
Yang, Sida
author_facet Song, Yongling
Li, Suyun
Xiao, Weiqiang
Shen, Jun
Ma, Wencheng
Wang, Qiang
Yang, Haomei
Liu, Guangming
Hong, Yan
Li, Peiqing
Yang, Sida
author_sort Song, Yongling
collection PubMed
description BACKGROUND: Although influenza primarily affects the respiratory system, it can cause severe neurological complications, especially in younger children, but knowledge about the early indicators of acute necrotizing encephalopathy (ANE) is limited. The main purpose of this article is to summarize the clinical characteristics, diagnosis, and treatment of neurological complications of influenza in children, and to identify factors associated with ANE. MATERIAL/METHODS: This was a retrospective study of children with confirmed influenza with neurological complications treated between 01/2014 and 12/2019 at Guangzhou Women and Children’s Medical Center. A receiver operating characteristics curve analysis was performed to determine the prognostic value of selected variables. RESULTS: Sixty-three children with IAE (n=33) and ANE (n=30) were included. Compared with the IAE group, the ANE group showed higher proportions of fever and acute disturbance of consciousness, higher alanine aminotransferase, higher aspartate aminotransferase, higher creatinine kinase, higher procalcitonin, higher cerebrospinal fluid (CSF) protein, and lower CSF white blood cells (all P<0.05). The areas under the curve (AUCs) for procalcitonin and CSF proteins, used to differentiate IAE and ANE, were 0.790 and 0.736, respectively. The sensitivity and specificity of PCT >4.25 ng/ml to predict ANE were 73.3% and 100.0%, respectively. The sensitivity and specificity of CSF protein >0.48 g/L to predict ANE were 76.7% and 69.7%, respectively. Thirteen (43.3%) children with ANE and none with IAE died (P<0.0001). CONCLUSIONS: High levels of CSF protein and serum procalcitonin might be used as early indicators for ANE. All children admitted with neurological findings, especially during the influenza season, should be evaluated for influenza-related neurological complications.
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spelling pubmed-77890502021-01-11 Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study Song, Yongling Li, Suyun Xiao, Weiqiang Shen, Jun Ma, Wencheng Wang, Qiang Yang, Haomei Liu, Guangming Hong, Yan Li, Peiqing Yang, Sida Med Sci Monit Clinical Research BACKGROUND: Although influenza primarily affects the respiratory system, it can cause severe neurological complications, especially in younger children, but knowledge about the early indicators of acute necrotizing encephalopathy (ANE) is limited. The main purpose of this article is to summarize the clinical characteristics, diagnosis, and treatment of neurological complications of influenza in children, and to identify factors associated with ANE. MATERIAL/METHODS: This was a retrospective study of children with confirmed influenza with neurological complications treated between 01/2014 and 12/2019 at Guangzhou Women and Children’s Medical Center. A receiver operating characteristics curve analysis was performed to determine the prognostic value of selected variables. RESULTS: Sixty-three children with IAE (n=33) and ANE (n=30) were included. Compared with the IAE group, the ANE group showed higher proportions of fever and acute disturbance of consciousness, higher alanine aminotransferase, higher aspartate aminotransferase, higher creatinine kinase, higher procalcitonin, higher cerebrospinal fluid (CSF) protein, and lower CSF white blood cells (all P<0.05). The areas under the curve (AUCs) for procalcitonin and CSF proteins, used to differentiate IAE and ANE, were 0.790 and 0.736, respectively. The sensitivity and specificity of PCT >4.25 ng/ml to predict ANE were 73.3% and 100.0%, respectively. The sensitivity and specificity of CSF protein >0.48 g/L to predict ANE were 76.7% and 69.7%, respectively. Thirteen (43.3%) children with ANE and none with IAE died (P<0.0001). CONCLUSIONS: High levels of CSF protein and serum procalcitonin might be used as early indicators for ANE. All children admitted with neurological findings, especially during the influenza season, should be evaluated for influenza-related neurological complications. International Scientific Literature, Inc. 2021-01-03 /pmc/articles/PMC7789050/ /pubmed/33388740 http://dx.doi.org/10.12659/MSM.928374 Text en © Med Sci Monit, 2021 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Song, Yongling
Li, Suyun
Xiao, Weiqiang
Shen, Jun
Ma, Wencheng
Wang, Qiang
Yang, Haomei
Liu, Guangming
Hong, Yan
Li, Peiqing
Yang, Sida
Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title_full Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title_fullStr Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title_full_unstemmed Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title_short Influenza-Associated Encephalopathy and Acute Necrotizing Encephalopathy in Children: A Retrospective Single-Center Study
title_sort influenza-associated encephalopathy and acute necrotizing encephalopathy in children: a retrospective single-center study
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789050/
https://www.ncbi.nlm.nih.gov/pubmed/33388740
http://dx.doi.org/10.12659/MSM.928374
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