Kawamura Yoshiki, Ohashi Masahiro, Ihira Masaru, Hashimoto Shuji, Taniguchi Koki, Yoshikawa Tetsushi
Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan.
Brain Dev. 2014 Aug;36(7):601-7. doi: 10.1016/j.braindev.2013.07.013. Epub 2013 Aug 21.
Rotavirus can cause severe complications such as encephalopathy/encephalitis and sudden unexpected death. The incidence of rotavirus-associated encephalopathy/encephalitis or sudden unexpected death remains unknown. To clarify the clinical features of rotavirus-associated encephalitis/encephalopathy and sudden unexpected death, we conducted a nationwide survey in Japan.
A two-part questionnaire was designed to determine the number of the cases and the clinical features of severe cases of rotavirus infection, including encephalitis/encephalopathy and sudden unexpected death, between 2009 and 2011.
Of the 1365 questionnaires sent to hospitals, 963 (70.5%) were returned and eligible for analysis. We determined 58 cases of rotavirus-associated encephalitis/encephalopathy and 7 cases of sudden unexpected death. These patients were diagnosed with rotavirus infection by immunochromatography. Although 36/58 (62.1%) encephalitis/encephalopathy patients had no sequelae, 15/58 (25.9%) patients had neurological sequelae, and 7/58 (12.1%) patients had fatal outcomes. Pleocytosis was observed in 9/40 (22.5%) patients and cerebrospinal fluid protein levels were elevated in only 4/40 (10%) patients. Elevated lactate dehydrogenase (LDH) (>500 IU/L) or acidemia (pH<7.15) were related to a poor prognosis.
We estimate that annual cases of rotavirus-associated encephalitis/encephalopathy and sudden unexpected death were 44.0 and 4.9 cases in Japan, respectively. Elevated LDH (>500 IU/L) or acidemia (pH<7.15) were related to a poor prognosis of the encephalitis/encephalopathy.
轮状病毒可引发严重并发症，如脑病/脑炎和意外猝死。轮状病毒相关脑病/脑炎或意外猝死的发病率尚不清楚。为阐明轮状病毒相关脑炎/脑病及意外猝死的临床特征，我们在日本开展了一项全国性调查。
设计了一份包含两部分的调查问卷，以确定2009年至2011年间轮状病毒感染严重病例的数量及临床特征，这些严重病例包括脑炎/脑病和意外猝死。
向医院发送的1365份调查问卷中，963份（70.5%）被退回且符合分析条件。我们确定了58例轮状病毒相关脑炎/脑病病例和7例意外猝死病例。这些患者通过免疫层析法被诊断为轮状病毒感染。虽然58例脑炎/脑病患者中有36例（62.1%）没有后遗症，但15例（25.9%）患者有神经后遗症，7例（12.1%）患者死亡。40例患者中有9例（22.5%）出现脑脊液细胞数增多，仅4例（10%）患者脑脊液蛋白水平升高。乳酸脱氢酶（LDH）升高（>500 IU/L）或酸血症（pH<7.15）与预后不良有关。
我们估计在日本，每年轮状病毒相关脑炎/脑病和意外猝死的病例数分别为44.0例和4.9例。LDH升高（>500 IU/L）或酸血症（pH<7.15）与脑炎/脑病的不良预后有关。
