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Diagnostic odyssey of acute disseminated encephalomyelitis in children
We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time between sympto...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578490/ https://www.ncbi.nlm.nih.gov/pubmed/34754056 http://dx.doi.org/10.1038/s41598-021-01519-5 |
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author | Takahashi, Yoko Hayakawa, Itaru Abe, Yuichi |
author_facet | Takahashi, Yoko Hayakawa, Itaru Abe, Yuichi |
author_sort | Takahashi, Yoko |
collection | PubMed |
description | We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time between symptom onset and ADEM diagnosis), physicians’ delay (between the first medical visit and ADEM diagnosis), and patients’ delay (between symptom onset and the first medical visit) were analysed. Thirty ADEM patients were identified, including 16 (54%) with neurological deficits at discharge. Overall, physicians’, and patients’ delays were 9 (interquartile range [IQR] 6–20.5), 5.5 (IQR 3–14), and 4 (IQR 2–8) days, respectively. Overall delay was significantly associated with physicians’ delay, but not with patients’ delay. There were 61 misdiagnoses among 25 (83%) patients, while 5 (17%) were diagnosed correctly at the first visit. The misdiagnoses of common respiratory and gastrointestinal infection and aseptic meningitis were associated with overall and/or physicians’ delay. Later onset of specific neurological features suggestive of ADEM was associated with all three diagnostic delays. A unique diagnostic odyssey exists in ADEM. Several clinical risk factors were associated with the diagnostic delay. |
format | Online Article Text |
id | pubmed-8578490 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-85784902021-11-10 Diagnostic odyssey of acute disseminated encephalomyelitis in children Takahashi, Yoko Hayakawa, Itaru Abe, Yuichi Sci Rep Article We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time between symptom onset and ADEM diagnosis), physicians’ delay (between the first medical visit and ADEM diagnosis), and patients’ delay (between symptom onset and the first medical visit) were analysed. Thirty ADEM patients were identified, including 16 (54%) with neurological deficits at discharge. Overall, physicians’, and patients’ delays were 9 (interquartile range [IQR] 6–20.5), 5.5 (IQR 3–14), and 4 (IQR 2–8) days, respectively. Overall delay was significantly associated with physicians’ delay, but not with patients’ delay. There were 61 misdiagnoses among 25 (83%) patients, while 5 (17%) were diagnosed correctly at the first visit. The misdiagnoses of common respiratory and gastrointestinal infection and aseptic meningitis were associated with overall and/or physicians’ delay. Later onset of specific neurological features suggestive of ADEM was associated with all three diagnostic delays. A unique diagnostic odyssey exists in ADEM. Several clinical risk factors were associated with the diagnostic delay. Nature Publishing Group UK 2021-11-09 /pmc/articles/PMC8578490/ /pubmed/34754056 http://dx.doi.org/10.1038/s41598-021-01519-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Takahashi, Yoko Hayakawa, Itaru Abe, Yuichi Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title | Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title_full | Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title_fullStr | Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title_full_unstemmed | Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title_short | Diagnostic odyssey of acute disseminated encephalomyelitis in children |
title_sort | diagnostic odyssey of acute disseminated encephalomyelitis in children |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578490/ https://www.ncbi.nlm.nih.gov/pubmed/34754056 http://dx.doi.org/10.1038/s41598-021-01519-5 |
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