Abstract
Autoimmune pathology of acute disseminated encephalomyelitis (ADEM) is generally restricted to the brain. Our objective is to expand the phenotype of ADEM. A four-year-old girl was admitted to the pediatric emergency room of a university medical center five days after a common upper respiratory tract infection. Acute symptoms were fever, leg pain, and headaches. She developed meningeal signs, and her level of consciousness dropped rapidly. Epileptic seizure activity started, and she became comatose, requiring intubation and mechanical ventilation. Serial brain magnetic resonance imaging (MRI) illustrated the fulminant development of ADEM. Treatment escalation with high-dose corticosteroids, immunoglobulins, and plasma exchange did not lead to clinical improvement. On day ten, the patient developed treatment-refractory cardiogenic shock and passed away. The postmortem assessment confirmed ADEM and revealed acute lymphocytic myocarditis, likely explaining the acute cardiac failure. Human metapneumovirus and picornavirus were detected in the tracheal secrete by PCR. Data sources-medical chart of the patient. This case is consistent with evidence from experimental findings of an association of ADEM with myocarditis as a postinfecti...Continue Reading
References
Dec 2, 2000·Brain : a Journal of Neurology·R C DaleB G Neville
Mar 1, 2005·Multiple Sclerosis : Clinical and Laboratory Research·John D Kriesel, William A Sibley
Jan 24, 2007·Critical Care Clinics·Alexander Kopelnik, Jonathan G Zaroff
May 23, 2007·Archives of Dermatology·Oliver InhoffDirk Schadendorf
Dec 19, 2009·Multiple Sclerosis : Clinical and Laboratory Research·E MawhinneyG V McDonnell
Dec 22, 2011·Lancet·Sandeep SagarLeslie T Cooper
Jan 28, 2014·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Maciej WybraniecLukasz Krzych
May 16, 2015·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Stacey K MardekianMark T Curtis
Jan 29, 2016·Neurology. Neuroimmunology and Neuroinflammation·Rick MagunJohn Provias
Apr 2, 2017·Neuropsychology Review·Karen L O BurtonRuth K Brunsdon
Jun 13, 2017·Clinical & Experimental Neuroimmunology·Ikuo TsunodaAh-Mee Park
Nov 17, 2017·Multiple Sclerosis and Related Disorders·Mary IypeShahanaz M Ahamed
Jun 8, 2018·Frontiers in Physiology·Bethan J CritchleyMichal Mielcarek
Jul 14, 2018·Radiology Case Reports·Ricardo UribeWilliam Quiceno
Dec 14, 2018·Brain & Development·Yukako YaeToyojiro Matsuishi
Jan 24, 2019·International Journal of Molecular Sciences·Ingo GerhauserAndreas Beineke
May 20, 2020·Critical Care Explorations·Christopher P Robinson, Katharina M Busl