Rona Günay, Arifoğlu Meral, Günbey Hediye P, Yükselmiş Ufuk
Department of Radiology, University of Health Sciences Kartal Lutfi Kırdar Training and Research Hospital, Kartal, 34890 Istanbul, Turkey.
Department of Pediatrics, University of Health Sciences Kartal Lutfi Kırdar Training and Research Hospital, Istanbul, Turkey.
SN Compr Clin Med. 2021;3(7):1528-1533. doi: 10.1007/s42399-021-00928-x. Epub 2021 Apr 25.
Other than respiratory symptoms, influenza A (H1N1) can rarely cause neurological complications in children and adults. In this article, we aimed to present H1N1-associated acute necrotizing encephalopathy (ANE) and asymmetrical involvement of posterior reversible encephalopathy syndrome (PRES) in a 30-month-old male patient with clinical and radiological imaging findings. The patient who presented to the hospital with febrile convulsion and lethargy had elevated liver enzymes and coagulopathy. The magnetic resonance (MR) examination revealed diffusion restriction in bilateral cerebellar white matter, thalami, and periventricular white matter which was consistent with ANE. Susceptibility-weighted imaging (SWI) sequence showed hemorrhage in bilateral thalami and cerebellar white matter. There was high signal on fluid-attenuated inversion recovery (FLAIR) sequences in right temporooccipital cortical, subcortical, and periventricular white matter suggestive of PRES. MR angiography showed vasculopathy which is supportive for PRES. This is the second case of H1N1-associated pediatric PRES reported in the literature.
除呼吸道症状外，甲型H1N1流感在儿童和成人中很少引起神经系统并发症。在本文中，我们旨在介绍一名30个月大男性患者中与H1N1相关的急性坏死性脑病（ANE）和后部可逆性脑病综合征（PRES）的不对称受累情况，并展示其临床和影像学检查结果。该患者因发热惊厥和嗜睡入院，存在肝酶升高和凝血功能障碍。磁共振（MR）检查显示双侧小脑白质、丘脑和脑室周围白质存在弥散受限，这与ANE相符。磁敏感加权成像（SWI）序列显示双侧丘脑和小脑白质有出血。液体衰减反转恢复（FLAIR）序列显示右侧颞枕叶皮质、皮质下及脑室周围白质呈高信号，提示PRES。MR血管造影显示血管病变，支持PRES的诊断。这是文献报道的第二例与H1N1相关的儿童PRES病例。
