Increased cytokines/chemokines and hyponatremia as a possible cause of clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with acute focal bacterial nephritis

Okada, Tokuji; Fujita, Yuji; Imataka, George; Takase, Nanako; Tada, Hayato; Sakuma, Hiroshi; Takanashi, Jun‐ichi

doi:10.1016/j.braindev.2021.07.008

Cited by 14 publications

(13 citation statements)

References 22 publications

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“…SARS-CoV-2 infection was also unlikely based on negative PCR result. Recently, increased cytokines/chemokines were demonstrated in patients with MERS associated with acute focal bacterial nephritis, which were normalized in several weeks [14]. In the current study, Patient 1 showed marked elevation of CSF IL-6 level according to cut-off value of lupus psychosis [10].…”

Section: Discussionsupporting

confidence: 53%

“…Contrast-enhanced MRI is useful to exclude acute disseminated encephalomyelitis though sole involvement of corpus callosum is rare [16]. Though neurological manifestations of CLOCCs are mild and can be reversible, patients with overt disturbance or alteration of consciousness, focal neurological deficits, or seizures, especially with progression as in our cases, are treated with steroids and immunoglobulin [3,5,9,13,14].…”

Section: Discussionmentioning

confidence: 82%

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Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Ohara

Shimizu

Kasamatsu³

et al. 2022

Neuroradiology

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A 23-year-old previously healthy man (Patient 1) and a 33-year-old woman with a past history of depression (Patient 2) developed neurological symptoms approximately 1 week after receipt of the first COVID-19 mRNA vaccination and deteriorated over the next week. Patient 1 reported nausea, headache, a high fever, and retrograde amnesia. Patient 2 reported visual disturbance, headache, dysarthria, a left forearm tremor, dysesthesia of the mouth and distal limbs, and visual agnosia. PCR test results for SARS-CoV-2 were negative. Complete blood cell count, biochemistry, and antibody test and cerebrospinal fluid test findings were unremarkable. Diffusion-weighted and fluid-attenuated inversion recovery MRI of the brain showed a high signal intensity lesion at the midline of the splenium of the corpus callosum compatible with cytotoxic lesions of the corpus callosum (CLOCCs). High-dose intravenous methylprednisolone improved their symptoms and imaging findings. CLOCCs should be considered in patients with neurological manifestation after COVID-19 vaccination.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 82%

Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Ohara

Shimizu

Kasamatsu³

et al. 2022

Neuroradiology

View full text Add to dashboard Cite

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“…It is probably due to a complication secondary to the inflammation and hypercytokinemia in infected subjects without any attributed causative agent in cerebrospinal fluid cultures. Some authors suggest a possible pathogenic role of hyponatremia for MERS [ 17 , 18 ]. In our report, both patients showed hyponatremia associated with MIS-V.…”

Section: Discussionmentioning

confidence: 99%

Two Pediatric Cases of Multisystem Inflammatory Syndrome with Overlapping Neurological Involvement Following SARS-CoV-2 Vaccination and Unknown SARS-CoV2 Infection: The Importance of Pre-Vaccination History

et al. 2022

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The SARS-CoV-2 vaccine roll-out has been successful around the world. However, there are increasing concerns about adverse events. We report two pediatric cases of Multisystem-Inflammatory-Syndrome (MIS-C) with neurological involvement that occurred after SARS-CoV-2 vaccination and unknown recent SARS-CoV-2 infection. Brain magnetic resonance revealed mild-encephalopathy with reversible-splenial-lesion in both cases and complete resolution within 4 weeks. In conclusion, this report aims to describe rare emerging clinical entities that can help pediatricians to make an early diagnosis and to provide appropriate treatment. Multisystem-Inflammatory-Syndromes following COVID-19 vaccination remain rare events. When a history of a recent contact with SARS-CoV-2 is present, a careful evaluation by the clinicians in charge of immunization activities is suggested prior to proceeding with the vaccination.

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“…However, the exact pathogenesis of MERS is not fully understood. MERS has been reported in children with Kawasaki disease ( 12 ) and urinary tract infections ( 13 ), conditions that involve inflammatory responses. In relation to COVID-19, MERS has been reported in children ( 5 , 9 , 10 ) and adults with MIS-C ( 6 , 7 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Mild encephalitis with a reversible splenial lesion associated with SARS-CoV-2 infection in a patient with MYRF variant

et al. 2022

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We report a 14-year-old girl with a heterozygous p. Gln403Arg variant in the MYRF gene, who had five episodes of encephalopathy. She experienced reduced consciousness, numbness in the arm, and impaired verbal communication from day 4 of SARS-CoV-2 infection. Magnetic resonance imaging of her head showed reduced water diffusion in the corpus callosum and deep white matter. These features were similar to those seen in her previous episodes of encephalopathy. She was treated with methylprednisolone pulse therapy and recovered completely within a week.

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Increased cytokines/chemokines and hyponatremia as a possible cause of clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with acute focal bacterial nephritis

Cited by 14 publications

References 22 publications

Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Cytotoxic lesions of the corpus callosum after COVID-19 vaccination

Two Pediatric Cases of Multisystem Inflammatory Syndrome with Overlapping Neurological Involvement Following SARS-CoV-2 Vaccination and Unknown SARS-CoV2 Infection: The Importance of Pre-Vaccination History

Case report: Mild encephalitis with a reversible splenial lesion associated with SARS-CoV-2 infection in a patient with MYRF variant

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