Clinical characteristics and prognosis of 13 cases of acute necrotizing encephalopathy of childhood / 中华实用儿科临床杂志

ABSTRACT

Objective:To analyze and summarize the clinical characteristics, diagnosis and treatment, head imaging changes and prognosis of acute necrotizing encephalopathy of childhood (ANEC), aiming to improve the understanding of this disease.Methods:Clinical data of 13 ANEC patients (there were 7 males and 6 females, the median age was 30 months) admitted to the Pediatric Intensive Care Unit (PICU) of Shengjing Hospital, China Medical University from January 2014 to December 2020 were retrospectively analyzed, including clinical manifestations, laboratory examinations, diagnosis and treatment procedures, and head imaging data.Survivors were followed up through telephone.Results:All patients had fever and convulsions before admission, and the median time between fever and consciousness disturbance was 48 hours.The magnetic resonance imaging scans showed symmetrical multifocal brain damages.All 13 patients used glucocorticoid treatment, 10 cases used human immunoglobulin treatment, 8 cases used plasma exchange treatment.A total of 7/13 patients died.Five children were regularly followed up, who presented normal height and weight development and normal immunity.One child had normal motor intelligence with the acceptable Pediatric Overall Performance Category Score, and the remaining 4 children had certain sequelae, mainly manifesting as slow speech speed and limited movement.Conclusions:ANEC mainly occurs in winter and young children with a high mortality.It progresses rapidly, and consciousness disturbance appears soon after fever and convulsion.Survivors usually have sequelae, mostly manifesting as slow speech speed and limited movement, which can be significantly improved after systematic rehabilitation treatment.