Acute hemorrhagic leukoencephalopathy associated with influenza A (H1N1) virus

Cisse, Fodé Abass; Antoine, Jean‐Christophe; Pillet, Sylvie; Jousserand, Guillemette; Reynaud-Salard, Marie; Camdessanché, Jean‐Philippe

doi:10.1007/s00415-010-5772-4

Cited by 10 publications

(7 citation statements)

References 6 publications

(6 reference statements)

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“…However, in our review of the literature, we found an overall mortality of 46.5%, which is substantially lower. Moreover, 14% of patients made a full recovery and returned to their premorbid neurological baseline (3,5,7,14,18,35), and 11% survived with only minor neurological sequelae (2,12,15,23,38). The reason for the better outcome in this systematic review compared to previous studies (3, 4) remains unclear.…”

Section: Discussionmentioning

confidence: 66%

Acute Hemorrhagic Leukoencephalitis: A Case and Systematic Review of the Literature

et al. 2020

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Objectives: To present a patient with acute hemorrhagic leukoencephalitis (AHLE) and a systematic review of the literature analyzing diagnostic procedures, treatment, and outcomes of AHLE. Methods: PubMed and Cochrane databases were screened. Papers published since 01/01/2000 describing adult patients are reported according to the PRISMA-guidelines. Results: A 59-year old male with rapidly developing coma and cerebral biopsy changes compatible with AHLE is presented followed by 43 case reports from the literature including males in 67% and a mean age of 38 years. Mortality was 47%. Infectious pathogens were reported in 35%, preexisting autoimmune diseases were identified in 12%. Neuroimaging revealed uni-or bihemispheric lesions in 65% and isolated lesions of the cerebellum, pons, medulla oblongata or the spinal cord without concomitant hemispheric involvement in 16%. Analysis of the cerebrospinal fluid showed an increased protein level in 87%, elevated white blood cells in 65%, and erythrocytes in 39%. Histology (reported in 58%) supported the diagnosis of AHLE in all cases. Glucocorticoids were used most commonly (97%), followed by plasmapheresis (26%), and intravenous immunoglobulins (12%), without a clear temporal relationship between treatment and the patients' clinical course. Conclusions: Although mortality was lower than previously reported, AHLE remains a life-threatening neurologic emergency with high mortality. Diagnosis is challenging as the level of evidence regarding the diagnostic yield of clinical, neuroimaging and laboratory characteristics remains low. Hence, clinicians are urged to heighten their awareness and to prompt cerebral biopsies in the context of rapidly progressive neurologic decline of unknown origin with the concurrence of the compiled characteristics. Future studies need to focus on treatment characteristics and their effects on course and outcome.

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Section: Discussionmentioning

confidence: 66%

Acute Hemorrhagic Leukoencephalitis: A Case and Systematic Review of the Literature

et al. 2020

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“…ADEM typically manifests on imaging as subcortical and central white matter lesions and lesions at the cortical gray-white matter junction, although periventricular white matter and gray matter of the cortex, thalamus, and basal ganglia may also be involved [73]. Acute hemorrhagic leukoencephalitis, also known as Weston Hurst syndrome, is a fulminant form of ADEM [74]…”

Section: Accepted Manuscript Meningitis/encephalitismentioning

confidence: 99%

The Spectrum of Neuroimaging Findings on CT and MRI in Adults With COVID-19

Moonis

Filippi

Kirsch

et al. 2021

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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“…The most worrisome neurological sequale of H1N1 is a rare variant of H1N1 called acute necrotizing encephalopathy (ANE), or acute hemorrhagic encephalomyelitis; which is the most morbid form of ADEM [23][24][25][26]. The pertinent radiological features in this rare category are the extensive white matter changes and presence of small sized haemorrhages [27]. The disease, which is occasionally named Hurst disease, is usually fatal or at least severely devastating.…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Disseminated Encephalomyelitis Following Swine Influenza Virus (H1N1) Infection in Children

AM¹,

Elmagrabi²

2015

J Med Diagn Meth

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Background: Neurological complications of influenza viral infection have rarely been discussed in current literature. In the era of recent outbreaks of this potentially serious viral illness, understanding of possible extrapulmonary clinical manifestations is crucially needed. Case report:We are reporting two toddler girls who have been endorsed as previously healthy. Both patients have presented with a febrile respiratory illness followed by severe encephalopathy needing intensive care unit admission. They have been found to have novel H1N1 infection. Their neuroimaging studies were consistent with severe acute disseminated encephalomyelitis (ADEM). Good response to immunotherapy has been luckily achieved.Discussion: ADEM is an acute autoimmune encephalopathy disease which is commonly triggered by viral illnesses. However, particular correlation with novel H1N1 viral infection is not well described. Whether H1N1 triggers more severe clinical and radiological variant of ADEM is not yet precisely known, though has been observed in our study. Current knowledge in regard to neurological burden of H1N1 infection is reviewed. Conclusion:It is likely that H1N1 can trigger a more severe form of ADEM in children. Early suspicion and isolation of H1N1 virus in children who present with acute unexplained encephalopathy in the context of any viral illness seems to be a recommended practice.

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Acute hemorrhagic leukoencephalopathy associated with influenza A (H1N1) virus

Cited by 10 publications

References 6 publications

Acute Hemorrhagic Leukoencephalitis: A Case and Systematic Review of the Literature

Acute Hemorrhagic Leukoencephalitis: A Case and Systematic Review of the Literature

The Spectrum of Neuroimaging Findings on CT and MRI in Adults With COVID-19

Severe Acute Disseminated Encephalomyelitis Following Swine Influenza Virus (H1N1) Infection in Children

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