Marked elevation of interleukin-6 in mild encephalopathy with a reversible splenial lesion (MERS) associated with acute focal bacterial nephritis caused by Enterococcus faecalis

被引：39

作者：

Kometani, Hiroshi ^{[1
]}

Kawatani, Masao ^{[1
]}

Ohta, Genrei ^{[1
]}

Okazaki, Shintaro ^{[1
]}

Ogura, Kazumasa ^{[1
]}

Yasutomi, Motoko ^{[1
]}

Tanizawa, Akihiko ^{[1
]}

Ohshima, Yusei ^{[1
]}

机构：

[1] Univ Fukui, Fac Med Sci, Dept Pediat, Fukui 9101193, Japan

来源：

BRAIN & DEVELOPMENT | 2014年 / 36卷 / 06期

关键词：

Encephalitis; Encephalopathy; Splenium; Corpus callosum; Acute focal bacterial nephritis; Cytokine;

D O I：

10.1016/j.braindev.2013.07.012

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

This report describes two cases of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) associated with acute focal bacterial nephritis (AFBN). The patients, who presented with fever and delirious behavior, exhibited hyponatremia and markedly elevated interleukin (IL)-6 in cerebrospinal fluid (CSF) and serum. Enterococcus faecalis was detected in the urine culture. After ampicillin treatment, their consciousness improved without neurological sequelae. Moreover, a diffusion-weighted MRI abnormality, i.e., intensified signals in splenium of the corpus callosum, disappeared. MERS is a possible complication of AFBN. Elevated CSF IL-6 levels suggest that remote activation of intracerebral immune response through the immune neuroendocrine pathway might play an important role in the pathophysiology of MERS. (C) 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

引用

页码：551 / 553

页数：3

共 10 条

[1] The blood-brain barrier and immune function and dysfunction [J].

Banks, William A. ;

Erickson, Michelle A. .

NEUROBIOLOGY OF DISEASE, 2010, 37 (01) :26-32

[2]

Fujiwara Y, 2012, J JAPAN PEDIAT SOC, V116, P1880

[3] Serum and CSF levels of cytokines in acute encephalopathy following prolonged febrile seizures [J].

Ichlyama, Takashi ;

Suenaga, Naoko ;

Kajimoto, Madoka ;

Tohyama, Jun ;

Isumi, Hiroshi ;

Kubota, Masaya ;

Mori, Masato ;

Furukawa, Susumu .

BRAIN & DEVELOPMENT, 2008, 30 (01) :47-52

[4] Marked elevation of interferon-γ in acute focal bacterial nephritis [J].

Kashiwagi, Yasuyo ;

Kawashima, Hisashi ;

Nara, Shonosuke ;

Ushio, Masanobu ;

Nishimata, Shigeo .

CLINICAL AND EXPERIMENTAL NEPHROLOGY, 2012, 16 (04) :656-657

[5] Oxidative stress in patients with clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) [J].

Miyata, Rie ;

Tanuma, Naoyuki ;

Hayashi, Masaharu ;

Imamura, Takuji ;

Takanashi, Jun-ichi ;

Nagata, Rieko ;

Okumura, Akihisa ;

Kashii, Hirohumi ;

Tomita, Sunao ;

Kumada, Satoko ;

Kubota, Masaya .

BRAIN & DEVELOPMENT, 2012, 34 (02) :124-127

[6] ACUTE FOCAL BACTERIAL NEPHRITIS (ACUTE LOBAR NEPHRONIA) [J].

ROSENFIELD, AT ;

GLICKMAN, MG ;

TAYLOR, KJW ;

CRADE, M ;

HODSON, J .

RADIOLOGY, 1979, 132 (03) :553-561

[7] Acute focal bacterial nephritis in 25 children [J].

Seidel, Tanja ;

Kuwertz-Broeking, Eberhard ;

Kaczmarek, Sigrid ;

Kirschstein, Martin ;

Frosch, Michael ;

Bulla, Monika ;

Harms, Erik .

PEDIATRIC NEPHROLOGY, 2007, 22 (11) :1897-1901

[8] Hyponatremia and Inflammation: The Emerging Role of Interleukin-6 in Osmoregulation [J].

Swart, Reinout M. ;

Hoorn, Ewout J. ;

Betjes, Michiel G. ;

Zietse, Robert .

NEPHRON PHYSIOLOGY, 2011, 118 (02) :45-51

[9] Two newly proposed infectious encephalitis/encephalopathy syndromes [J].

Takanashi, Jun-ichi .

BRAIN & DEVELOPMENT, 2009, 31 (07) :521-528

[10] Encephalopathy with a reversible splenial lesion is associated with hyponatremia [J].

Takanashi, Jun-ichi ;

Tada, Hiroko ;

Maeda, Masayuki ;

Suzuki, Motomasa ;

Terada, Hitoshi ;

Barkovich, A. James .

BRAIN & DEVELOPMENT, 2009, 31 (03) :217-220

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