Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis

Abstract

Background: The hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disease that affects young children. The outcomes of HSES patients are often fatal or manifesting severe neurological sequelae. We reviewed the markers for an early diagnosis of HSES.

Early risk factors for mortality in children with seizure and/or impaired consciousness accompanied by fever without known etiology

“…Inflammatory cytokines cause mitochondrial dysfunction, ultimately leading to organ failure, metabolic dysfunction, and mortality [18]. In various diseases, mitochondrial damage leads to the storage of Lac [18], as well as elevation of liver enzymes due to multiple organ failure [4].…”

“…Although FS and AE differ greatly in severity and outcome, it is often difficult to distinguish AE from FS in the early stages of the disease. Furthermore, children with a certain subtype of AE-hemorrhagic shock and encephalopathy syndrome (HSES) [3]-are almost always in critical condition and exhibit multiple organ failure (MOF) by the time of diagnosis [4]. Thus, early prediction of outcomes for children with SICF, prior to diagnosis, may help to reduce mortality associated with AE.…”

Successful Outcome in an Adult Patient with Influenza-associated Hemorrhagic Shock and Encephalopathy Syndrome

“…The pathogenesis of HSES is unclear. Systemic inflammation may be associated with this syndrome as well as IAE ( 15 , 16 ). In the literature, most patients with HSES were children, although an adult Japanese patient with HSES was recently reported ( 14 ).…”

“…CT and magnetic resonance imaging (MRI) usually illustrate no specific radiological findings ( 15 ). Laboratory tests reveal elevated liver enzyme and creatine kinase levels upon admission and persistence of acidosis despite fluid resuscitation ( 15 ). These early signs have been reported to indicate HSES ( 15 ).…”

A schizophrenic patient with cerebral infarctions after hemorrhagic shock

“…[1] For children, there is a clinical association between hemorrhagic shock and encephalopathy syndrome, however, this syndrome is due to the cerebrovascular injuries induced by disseminated intravascular coagulopathy triggered by infection, making this clinical entity different from cerebral infarction concomitant with hemorrhagic shock. [2] Takaoka et al . reported three adult cases of cerebral infarction after severe hemorrhagic shock, who required a large amount of blood via transfusion, ranging from 5 to 12 L.[3] They hypothesized that the mechanism responsible for these complications was a cerebral infarction induced by hemodynamic insufficiency triggered by hemorrhagic shock, because the location of the cerebral infarctions coincided with the boundary zones where functional anastomoses between the two arterial systems existed.…”