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由于疫苗接种覆盖率低导致亚急性硬化性全脑炎再次出现:病例系列报告

Subacute sclerosing panencephalitis as a re-emerging condition due to low vaccination coverage: a case-series.

作者信息

Errichiello Gabriella, Tengattini Francesco, Gioacchini Silvia, De Leva Maria Fulvia, Graziano Stefania, Bruno Giorgia, Bucci Paola, D'Ugo Emilio, Ruggiero Claudio, Magurano Fabio, Varone Antonio

机构信息

Pediatric Neurology Unit, Department of Neurosciences, Santobono-Pausilipon Children's Hospital, Naples, Italy.

Child Neuropsychiatry Unit, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.

出版信息

Ital J Pediatr. 2025 Jun 7;51(1):173. doi: 10.1186/s13052-025-02026-3.

DOI:10.1186/s13052-025-02026-3
PMID:40483442
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12145622/
Abstract

BACKGROUND

Subacute sclerosing panencephalitis (SSPE) is a chronic progressive disease affecting the central nervous system (CNS) because of persistent measles virus (MeV) infection. The disease presents with a range of symptoms, starting with gradual cognitive and motor decline, progressing to coma, vegetative state, and typically resulting in death within 3-4 years of clinical onset. The incidence of SSPE is inversely related to vaccination coverage and its pathogenesis remains poorly understood. The primary risk factor is infection by the wild type of measles virus, particularly in individuals who may be predisposed to infection due to a lack of herd immunity or immunosuppressed states. Furthermore, the risk of developing SSPE increases with the younger age at which a person contracts measles.

CASE PRESENTATION

We provide a description of the disease, characterizing its clinical course, diagnostic work-up and treatment options. We will also present a series of cases observed at the Santobono-Pausilipon Children's Hospital, in Naples, Italy, highlighting both typical and atypical presentations, with a particular emphasis on the pharmacological and neurosurgical treatments for the condition.

CONCLUSIONS

The objective of this study is to raise awareness about the increasing prevalence of conditions following the SARS-Cov2 pandemic, with an emphasis on the importance of vaccination adherence as the only effective prevention method for SSPE.

摘要

背景

亚急性硬化性全脑炎(SSPE)是一种由于持续性麻疹病毒(MeV)感染而影响中枢神经系统(CNS)的慢性进行性疾病。该疾病表现出一系列症状,始于逐渐的认知和运动功能衰退,进展至昏迷、植物人状态,通常在临床发病后3至4年内导致死亡。SSPE的发病率与疫苗接种覆盖率呈负相关,其发病机制仍知之甚少。主要危险因素是野生型麻疹病毒感染,特别是在由于缺乏群体免疫或处于免疫抑制状态而可能易受感染的个体中。此外,患麻疹时年龄越小,发生SSPE的风险越高。

病例介绍

我们对该疾病进行了描述,包括其临床病程、诊断检查和治疗选择。我们还将介绍在意大利那不勒斯的圣托博诺-帕西里蓬儿童医院观察到的一系列病例,突出典型和非典型表现,特别强调针对该病症的药物治疗和神经外科治疗。

结论

本研究的目的是提高对SARS-CoV2大流行后疾病患病率上升的认识,强调坚持接种疫苗作为预防SSPE唯一有效方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/380614fbdbdf/13052_2025_2026_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/0358f35f7227/13052_2025_2026_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/ee677c955628/13052_2025_2026_Fig4_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/f062cb32a731/13052_2025_2026_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/380614fbdbdf/13052_2025_2026_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/0358f35f7227/13052_2025_2026_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/ec04c62bddba/13052_2025_2026_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/180fb106ff5c/13052_2025_2026_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/ee677c955628/13052_2025_2026_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/435d4211f0d0/13052_2025_2026_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/109a53ca1c34/13052_2025_2026_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/f062cb32a731/13052_2025_2026_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4af6/12145622/380614fbdbdf/13052_2025_2026_Fig8_HTML.jpg

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本文引用的文献

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Group B streptococcus colonization in pregnancy and neonatal outcomes: a three-year monocentric retrospective study during and after the COVID-19 pandemic.妊娠期 B 群链球菌定植与新生儿结局:COVID-19 大流行期间及之后三年的单中心回顾性研究。
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