A Case of Influenza-associated Encephalopathy

인플루엔자 관련 뇌증 1례

Influenza-associated encephalopathy is regarded as one of the major neurologic disease entities along with those of Reye syndrome, acute necrotizing encephalopathy, and myelitis which are known to be related to influenza virus, mostly type A. And it is being actively researched in Japan as it has caused a tremendous increase in the number of deaths from 1997 to 2002, but it has not been yet reported in the Korean pediatric medical community. It attacks those previously healthy children, who have not been vaccinated. Patients start with such symptoms as fever and common respiratory problems, but within 24 to 48 hours they suffer from seizures with acute mental deterioration, become worse, and suffer multiple organ failures including marked elevated transaminase levels as well as coagulopathy. It induces deaths in a couple of days after the symptoms appear or remains a serious neurologic sequelae. Confirmative diagnosis is used to demonstrate influenza viral infection. We report here a 37 month aged boy who was admitted to our hospital during the last influenza season under the diagnosis of influenza associated encephalopathy on the basis of serologic testing by hemagglutinin inhibition(HI). This is the first report confirmed by increased antibody titer of the influenza A virus in Korea.

저자들은 인플루엔자 유행시기에, 생후 3년 1개월 환아에서 갑작스런 고열을 동반한 경련 발작과 의식소실을 주소로, 6일간 입원 치료에도 불구하고 급격한 급성 뇌증의 악화와 간기능수치 증가 및 신장기능 부전, 범발성 혈관내 응고증으로 사망한 남아에서 인플루엔자 바이러스 항체 검사상 A/H1N1에 대한 HI titer가 초 회 항체 역가의 4배 이상 증가됨을 관찰하여 국내에는 보고된 예가 없는 급성 인플루엔자 뇌증으로 진단한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.