Acute Necrotizing Encephalopathy by Mycoplasma pneumoniae Infection?

Narita, Mitsuo

doi:10.1001/archinte.162.14.1647-a

Cited by 9 publications

(5 citation statements)

References 10 publications

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“…Recently, SARS-CoV2 (also referred to as COVID-19) has been associated with the onset of ANE, adding to the existing literature of viral trigger phenomenon observed in the disease (Poyiadji et al, 2020). While most cases are associated with preceding viral infection, some cases have also been reported secondary to mycoplasma pneumonia and the diphtheria-tetanus-whole cell pertussis vaccine (San Millan et al, 2007, Narita, 2002, Ashtekar et al, 2003. Interestingly, while the course and outcome of ANE1 vary, this variability does not depend on the inciting agent, indicating that a genetic predisposition to immune dysregulation is more likely the etiology than a specific antigenic trigger (Neilson, 2010).…”

Section: Immune Dysregulation and Antigenic Responsementioning

confidence: 99%

Genetic Acute Necrotizing Encephalopathy Associated with RANBP2: Clinical and Therapeutic Implications in Pediatrics

Levine

Ahsan

et al. 2020

Multiple Sclerosis and Related Disorders

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Genetic (also known as familial) acute necrotizing encephalopathy (ANE1) is a rare disease presenting with encephalopathy often following preceding viral febrile illness in patients with a genetic predisposition resulting from a missense mutation in the gene encoding RAN Binding Protein 2 (RANBP2). The acute episode is characterized by deterioration in consciousness, often with focal neurologic deficits and seizures. Additionally, symmetric multifocal brain lesions are seen in the bilateral thalami as well as other characteristic regions, involving both gray and white matter. Prognosis is variable, with a high mortality rate and most surviving patients having persistent neurologic deficits. Early treatment with high dose steroids is associated with a more favorable outcome, however the diagnosis is often overlooked resulting in delayed treatment. The RANBP2 mutation associated with ANE1 causes an incompletely penetrant predisposition to encephalopathy in the setting of febrile illness through a mechanism that remains elusive. There are several non-mutually exclusive hypotheses suggesting possible etiologies for this phenotype based on the many functions of RANBP2 within the cell. These include dysfunctions in nucleocytoplasmic trafficking and intracellular metabolic regulation, as well as cytokine storm, and abnormal distribution of mitochondria. This narrative review explores these key concepts of the RANBP2 mutation and its clinical and therapeutic implications in pediatric populations.

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Section: Immune Dysregulation and Antigenic Responsementioning

confidence: 99%

Genetic Acute Necrotizing Encephalopathy Associated with RANBP2: Clinical and Therapeutic Implications in Pediatrics

Levine

Ahsan

et al. 2020

Multiple Sclerosis and Related Disorders

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“…However, neurological manifestations in the central nervous system (CNS) associated with M. pneumoniae infections are increasingly being reported as physicians are more aware of this relationship [2][3][4][5]. We describe herein a 60-year-old woman who developed meningitis associated with bilateral optic papillitis following M. pneumoniae infection and discuss the possible mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Meningitis associated with bilateral optic papillitis following Mycoplasma pneumoniae infection

et al. 2011

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Mycoplasma pneumoniae (M. pneumoniae) is a frequent cause for human infection, and central nervous system disease associated with M. pneumoniae infection is being reported with increasing frequency. We described herein a 60-year-old woman who developed meningitis associated with bilateral optic papillitis following M. pneumoniae infection and discussed the possible mechanisms. To our knowledge, there have been only a few reports that described the meningitis complicated by bilateral optic papillitis in association with M. pneumoniae infection. Our case highlighted the protean neurological manifestations of M. pneumoniae infection.

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“…The clinical entity of acute necrotizing encephalopathy was established by Mizuguchi and colleagues on the basis of accumulated clinicopathologic data from 55 Oriental children living in the Far East. 1,2 Since then, a limited number of case reports have been published, with emphasis on the occurrence of the disease in other racial groups, [3][4][5] the identification of specific viral pathogens, [4][5][6][7][8] and a better outcome than originally suggested. 5,7,9 The association of parainfluenza virus infection observed in this case has not been previously described.…”

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confidence: 99%

Acute Necrotizing Encephalopathy Associated With Parainfluenza Virus in a Caucasian Child

Mastroyianni

Voudris²,

Katsarou³

et al. 2003

J Child Neurol

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Acute necrotizing encephalopathy is a severe parainfectious disorder with a clear racial predilection for Oriental children living in the Far East. The prognosis was originally reported as grave; however, a mild form of the disease has recently been described. A case of parainfluenza virus-associated acute necrotizing encephalopathy in a Caucasian child with a mild clinical course and excellent prognosis is presented. In this patient, the initial clinical picture was not very impressive, and the diagnosis was delayed until the third week of the illness, when neuroimaging was performed. Two months later, clinical and neuroimaging findings had almost completely resolved. Suggested criteria for a benign prognosis, such as normal liver function and cerebrospinal fluid protein levels, asymmetric thalamic lesions, and no brainstem involvement, were relevant in the present case. An extended diagnostic work-up for metabolic, vascular, coagulation, and infectious diseases was negative apart from a seroconversion for parainfluenza virus. To our knowledge, this is the first reported case of acute necrotizing encephalopathy associated with parainfluenza virus infection. Acute necrotizing encephalopathy, especially in the mild form, might not be fully recognized and could be underdiagnosed in Europe, where the reported incidence of the syndrome is very low.

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Acute Necrotizing Encephalopathy by Mycoplasma pneumoniae Infection?

Cited by 9 publications

References 10 publications

Genetic Acute Necrotizing Encephalopathy Associated with RANBP2: Clinical and Therapeutic Implications in Pediatrics

Genetic Acute Necrotizing Encephalopathy Associated with RANBP2: Clinical and Therapeutic Implications in Pediatrics

Meningitis associated with bilateral optic papillitis following Mycoplasma pneumoniae infection

Acute Necrotizing Encephalopathy Associated With Parainfluenza Virus in a Caucasian Child

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