Chan G C, Kanwar V S, Wilimas J
Department of Haematology-Oncology, St. Jude Children's Research Hospital, University of Tennessee, Memphis, USA.
J Paediatr Child Health. 1998 Jun;34(3):299-301. doi: 10.1046/j.1440-1754.1998.00221.x.
Patients with transient erythroblastopenia of childhood (TEC) may also have a transient neurologic disorder. We present a case history and propose a mechanism for this syndrome. PATIENT AND METHODOLOGY: We describe a 20-month-old girl with TEC and transient hemiparesis. Records from the period January 1993 through December 1994 were reviewed to identify other patients with TEC and to determine whether neurologic deficits were noted in these cases.
Of seven patients diagnosed with TEC over a 2-year period, only one had a neurologic deficit. This child's hemiparesis resolved within 24 h after the appearance of her symptoms. Her TEC resolved within 4 weeks, without long-term sequelae. Our experience and review of the literature suggest that focal neurologic deficits in TEC patients are uncommon, transient, lack long-term sequelae, and usually resolve prior to hematologic recovery.
Previous reports suggested that the anaemia resulting from TEC might induce neurologic deficits. We suggest an alternative mechanism in which viral infection triggers a host immune response that independently leads to both TEC and neurologic abnormalities. Future studies should address the role of viral infection in TEC patients with focal neuropathies.
儿童一过性红细胞生成减少症(TEC)患者可能还会出现一过性神经系统疾病。我们呈现一个病例并提出该综合征的发病机制。患者与方法:我们描述一名患有TEC和一过性偏瘫的20个月大女童。回顾1993年1月至1994年12月期间的记录,以确定其他TEC患者,并判断这些病例中是否有神经功能缺损。
在2年期间诊断为TEC的7名患者中,只有1名有神经功能缺损。该患儿的偏瘫在症状出现后24小时内缓解。她的TEC在4周内缓解,无长期后遗症。我们的经验及文献回顾表明,TEC患者的局灶性神经功能缺损并不常见,是一过性的,无长期后遗症,且通常在血液学恢复之前就已缓解。
既往报道提示,TEC所致贫血可能诱发神经功能缺损。我们提出另一种机制,即病毒感染引发宿主免疫反应,独立导致TEC和神经异常。未来研究应关注病毒感染在患有局灶性神经病的TEC患者中的作用。