Abstract
Background: To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). Methods: The demographics data, clinical manifestations, and laboratory indicators of cases diagnosed with IANE and influenza with febrile convulsions (FS), respectively, admitted to Guangzhou Women and Children’s Medical Center from January 2016 to January 2020 were retrospectively analyzed. Results: Among the 25 cases of IANE, there were 9 males and 16 females, aged 3 to 6 years. The mortality rate was 40.00% (10/25). Influenza virus type A in 9 cases (36.00%) and influenza virus type B in 10 cases (40.00%). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE.
Highlights
Influenza is a highly contagious respiratory transmitted disease with a high prevalence in winter and spring
We review and compare the demographic data, clinical manifestations, and laboratory findings of a total of 25 cases hospitalized with a diagnosis of influenza-associated acute necrotizing encephalopathy (IANE) and 57 cases diagnosed with febrile convulsions (FS) from January 2016 to January 2020 in Guangzhou Women’s and Children’s Medical Center, aiming to explore the characteristic clinical manifestations and available biomarkers of IANE
Statistical differences were found between the two groups of children in gender, age, mortality, influenza virus type, impairment of consciousness, and a Variable Male (%) Age Month of onset December to February March to May June to August September to November Death (%) Influenza virus type FA (%) H1N1 (%) FB (%) Onset Fever > 39 ̊C Vomiting
Summary
Influenza is a highly contagious respiratory transmitted disease with a high prevalence in winter and spring. Influenza in children is a major cause of morbidity and mortality worldwide, with higher incidence rates each year. The typical clinical manifestations of influenza-infected persons are acute fever, muscle pain, headache, accompanied by respiratory symptoms. To explore the early clinical features and laboratory findings of influenza-associated acute necrotizing encephalopathy (IANE). The main clinical manifestations of children with IANE were acute disorders of consciousness (64.00%, 16/25) and convulsions (72.00%, 18/25), which were statistically significant when compared with the FS group (P < 0.05). Conclusions: Children with influenza present early with acute impairment of consciousness or convulsive seizures, or with elevated AST, ALT, CK-MB, LDH, and CSF protein and CSF LDH, especially if blood LDH is ≥348.5 U/L, should be closely evaluated and alerted to the possibility of IANE
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