Acute Necrotizing Encephalopathy of Childhood Associated With Influenza Type B Virus Infection in a 3-Year-Old Girl

Abstract

Acute necrotizing encephalopathy of childhood represents a novel entity of acute encephalophathy, predominantly affecting infants and young children living in Taiwan and Japan. It manifests with symptoms of coma, convulsions, and hyperpyrexia after 2 to 4 days of respiratory tract infections in previously healthy children. The hallmark of acute necrotizing encephalopathy of childhood consists of multifocal and symmetric brain lesions affecting the bilateral thalami, brainstem tegmentum, cerebral periventricular white matter, or cerebellar medulla. The etiology and pathogenesis of this kind of acute encephalopathy remain unknown, and there is no specific therapy or prevention. The prognosis is usually poor, and less than 10% of patients recover completely. We report a 3-year-old previously healthy girl presenting with acute necrotizing encephalopathy of childhood associated with influenza type B virus infection, which resulted in severe neurologic sequelae. We also review the current knowledge of the clinical, neuroimaging, and pathologic aspects of acute necrotizing encephalopathy of childhood.

Health Benefits, Risks, and Cost-Effectiveness of Influenza Vaccination of Children

“…We explicitly asked respondents to include a parent's reduction in quality of life associated with a child's illness and any time lost from work to care for a sick child in the time-tradeoff valuation; therefore, time-tradeoff amounts could exceed the length of the event. QALYs lost due to severely disabling long-term sequelae after influenza hospitalization, such as acute necrotizing encephalopathy with irreversible neurologic damage, were also included ( 23 , 24 ). An influenza-related death was assumed to result in the loss of 1 QALY for each year of life lost.…”

Clinical outcome of acute necrotizing encephalopathy in related to involving the brain stem of single institution in Korea

“…The mortality rate of ANE has been reported to reach about 30%, and most of the affected children die in the first week6,7,8,9,10,11). Survivors of ANE suffer from mild to moderate neurologic sequelae, and less than 10% of patients recover completely8,12).…”

“…There have been a few studies regarding prognostic factors of ANE such as early steroid treatment, magnetic resonance imaging (MRI) findings, or involvement of the brain stem2,8,12,13). However, additional data are still needed to firmly determine prognostic factors of ANE.…”

Effects of Adverse Events on the Projected Population Benefits and Cost-effectiveness of Using Live Attenuated Influenza Vaccine in Children Aged 6 Months to 4 Years

“…The QALYs lost to a disease or condition, therefore, measure the overall reduction in a patient's wellbeing, or health-related quality of life, due to an episode of disease and its consequences. We obtained QALY valuations for influenza-related and vaccination-related events from published studies conducted by us and from published data 25,27,37,38 (Table 1). A value for the QALYs lost because of an episode of wheezing in a child was not available.…”