インフルエンザウイルス感染に伴った急性壊死性脳症の2成人例

インフルエンザ脳症はインフルエンザ感染に続発し高熱，意識障害を主徴とする症候群である．我々は今回インフルエンザ感染後に両側視床に出血性病変を認めた急性壊死性脳症2成人例（症例1，糖尿病のある70歳女性；症例2，多発性骨髄腫のある49歳女性）を経験した．症例1は発熱，痙攣重積，意識障害で発症しインフルエンザA型陽性，症例2は発熱，傾眠で発症しインフルエンザB型が陽性であった．2例共に急性期は人工呼吸器管理を要し，抗インフルエンザ薬，ステロイド剤，免疫グロブリンで加療を行ったが高次脳機能障害が残存した．当疾患を疑った場合は早期からの集約的治療介入が重要である．...

Full description

Saved in:
Bibliographic Details
Published in臨床神経学 Vol. 60; no. 2; pp. 157 - 161
Main Authors 飯塚, 賢太郎, 鈴木, 圭輔, 舩越, 慶, 中村, 利生, 椎名, 智彦, 平田, 幸一
Format Journal Article
LanguageJapanese
Published 日本神経学会 2020
Subjects
インフルエンザウイルス感染
急性壊死性脳症
成人例
Online AccessGet full text
ISSN0009-918X
1882-0654
DOI10.5692/clinicalneurol.cn-001381

Cover

Abstract インフルエンザ脳症はインフルエンザ感染に続発し高熱，意識障害を主徴とする症候群である．我々は今回インフルエンザ感染後に両側視床に出血性病変を認めた急性壊死性脳症2成人例（症例1，糖尿病のある70歳女性；症例2，多発性骨髄腫のある49歳女性）を経験した．症例1は発熱，痙攣重積，意識障害で発症しインフルエンザA型陽性，症例2は発熱，傾眠で発症しインフルエンザB型が陽性であった．2例共に急性期は人工呼吸器管理を要し，抗インフルエンザ薬，ステロイド剤，免疫グロブリンで加療を行ったが高次脳機能障害が残存した．当疾患を疑った場合は早期からの集約的治療介入が重要である．
AbstractList インフルエンザ脳症はインフルエンザ感染に続発し高熱，意識障害を主徴とする症候群である．我々は今回インフルエンザ感染後に両側視床に出血性病変を認めた急性壊死性脳症2成人例（症例1，糖尿病のある70歳女性；症例2，多発性骨髄腫のある49歳女性）を経験した．症例1は発熱，痙攣重積，意識障害で発症しインフルエンザA型陽性，症例2は発熱，傾眠で発症しインフルエンザB型が陽性であった．2例共に急性期は人工呼吸器管理を要し，抗インフルエンザ薬，ステロイド剤，免疫グロブリンで加療を行ったが高次脳機能障害が残存した．当疾患を疑った場合は早期からの集約的治療介入が重要である．
Author 舩越, 慶
鈴木, 圭輔
平田, 幸一
椎名, 智彦
中村, 利生
飯塚, 賢太郎
Author_xml – sequence: 1
  fullname: 飯塚, 賢太郎
  organization: 獨協医科大学脳神経内科
– sequence: 1
  fullname: 鈴木, 圭輔
  organization: 獨協医科大学脳神経内科
– sequence: 1
  fullname: 舩越, 慶
  organization: 獨協医科大学脳神経内科
– sequence: 1
  fullname: 中村, 利生
  organization: リハビリテーション天草病院脳神経内科
– sequence: 1
  fullname: 椎名, 智彦
  organization: 獨協医科大学脳神経内科
– sequence: 1
  fullname: 平田, 幸一
  organization: 獨協医科大学脳神経内科
BookMark eNpVkMtKw0AYhQepYK19B18gdWaSSSdLKd6g6MaCu2EyndGUmEpSF-6atKDoRhBxmUW9QdFNRbCKLzM1-hi2VhA35z_n4-cszjzIBc1AArCIYInYDl4Svhd4gvuBPAybfkkEBoTIpGgG5BGl2IA2sXIgDyF0DAfRnTlQjCLPnWTiUGTlQU0n17oz0J1L3enr5H7ik2ed3P7wMXnJummWXui4P3p70nFPx2nWvsnadx-90-zhdWy-uoPPq2MdP-Ls5Hw0HI7ezxbArOJ-JIu_twBqqyvblXWjurW2UVmuGg1sY2jUsZSuFFK5CiIqHUWJZVOJ664iZSWocCyOxwyaZZtb1CVWXZlcUEKRsJHkZgFsTnsbUYvvSnYQevs8PGI8bHnCl-z_PsyGDE9EBGy609_jHg9Zg5vfknuHUg
ContentType Journal Article
Copyright 2020 日本神経学会
Copyright_xml – notice: 2020 日本神経学会
DOI 10.5692/clinicalneurol.cn-001381
DatabaseTitleList
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1882-0654
EndPage 161
ExternalDocumentID article_clinicalneurol_60_2_60_cn_001381_article_char_ja
GroupedDBID ALMA_UNASSIGNED_HOLDINGS
JSF
OK1
P2P
RJT
ID FETCH-LOGICAL-j2620-d2eebecefbf018e9f85468e2dbf57fc8c94a28540376a48b54df3ac8581c61ea3
ISSN 0009-918X
IngestDate Wed Sep 03 06:29:10 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 2
Language Japanese
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-j2620-d2eebecefbf018e9f85468e2dbf57fc8c94a28540376a48b54df3ac8581c61ea3
OpenAccessLink https://www.jstage.jst.go.jp/article/clinicalneurol/60/2/60_cn-001381/_article/-char/ja
PageCount 5
ParticipantIDs jstage_primary_article_clinicalneurol_60_2_60_cn_001381_article_char_ja
PublicationCentury 2000
PublicationDate 20200000
PublicationDateYYYYMMDD 2020-01-01
PublicationDate_xml – year: 2020
  text: 20200000
PublicationDecade 2020
PublicationTitle 臨床神経学
PublicationTitleAlternate 臨床神経学
PublicationYear 2020
Publisher 日本神経学会
Publisher_xml – name: 日本神経学会
References 2) Davis LE, Koster F, Cawthon A. Neurologic aspects of influenza viruses. Handb Clin Neurol 2014;123:619-645.
10) Fernandez-Blazquez A, Castanon-Apilanez M, Alvarez-Arguelles ME, et al. Neuroinvasion of influenza A/H3N2: a fatal case in an immunocompetent adult. J Neurovirol 2019;25:275-279.
15) Mizuguchi M, Abe J, Mikkaichi K, et al. Acute necrotising encephalopathy of childhood: a new syndrome presenting with multifocal, symmetric brain lesions. J Neurol Neurosurg Psychiatry 1995;58:555-561.
13) Fujimoto Y, Shibata M, Tsuyuki M, et al. Influenza A virus encephalopathy with symmetrical thalamic lesions. Eur J Pediatr 2000;159:319-321.
14) Mizuguchi M. Acute necrotizing encephalopathy of childhood: a novel form of acute encephalopathy prevalent in Japan and Taiwan. Brain Dev 1997;19:81-92.
8) Alsolami A, Shiley K. Successful treatment of influenza-associated acute necrotizing encephalitis in an adult using high-dose oseltamivir and methylprednisolone: case report and literature review. Open Forum Infect Dis 2017;4:ofx145.
12) Sell K, Storch K, Hahn G, et al. Variable clinical course in acute necrotizing encephalopathy and identification of a novel RANBP2 mutation. Brain Dev 2016;38:777-780.
4) Iijima H, Wakasugi K, Ayabe M, et al. A case of adult influenza A virus-associated encephalitis: magnetic resonance imaging findings. J Neuroimaging 2002;12:273-275.
1) Morita A, Ishihara M, Kamei S, et al. Nationwide survey of influenza-associated acute encephalopathy in Japanese adults. J Neurol Sci 2019;399:101-107.
3) Mizuguchi M, Yamanouchi H, Ichiyama T, et al. Acute encephalopathy associated with influenza and other viral infections. Acta Neurol Scand 2007;115:45-56.
11) Neilson DE. The interplay of infection and genetics in acute necrotizing encephalopathy. Curr Opin Pediatr 2010;22:751-757.
9) Ochi N, Takahashi K, Yamane H, et al. Acute necrotizing encephalopathy in an adult with influenza A infection. Ther Clin Risk Manag 2018;14:753-756.
5) Fasano A, Natoli GF, Cianfoni A, et al. Acute necrotizing encephalopathy: a relapsing case in a European adult. J Neurol Neurosurg Psychiatry 2008;79:227-228.
6) Lee YJ, Smith DS, Rao VA, et al. Fatal H1N1-related acute necrotizing encephalopathy in an adult. Case Rep Crit Care 2011;2011:562516.
7) Ishii N, Mochizuki H, Moriguchi-Goto S, et al. An autopsy case of elderly-onset acute necrotizing encephalopathy secondary to influenza. J Neurol Sci 2015;354:129-130.
References_xml – reference: 7) Ishii N, Mochizuki H, Moriguchi-Goto S, et al. An autopsy case of elderly-onset acute necrotizing encephalopathy secondary to influenza. J Neurol Sci 2015;354:129-130.
– reference: 13) Fujimoto Y, Shibata M, Tsuyuki M, et al. Influenza A virus encephalopathy with symmetrical thalamic lesions. Eur J Pediatr 2000;159:319-321.
– reference: 5) Fasano A, Natoli GF, Cianfoni A, et al. Acute necrotizing encephalopathy: a relapsing case in a European adult. J Neurol Neurosurg Psychiatry 2008;79:227-228.
– reference: 14) Mizuguchi M. Acute necrotizing encephalopathy of childhood: a novel form of acute encephalopathy prevalent in Japan and Taiwan. Brain Dev 1997;19:81-92.
– reference: 3) Mizuguchi M, Yamanouchi H, Ichiyama T, et al. Acute encephalopathy associated with influenza and other viral infections. Acta Neurol Scand 2007;115:45-56.
– reference: 8) Alsolami A, Shiley K. Successful treatment of influenza-associated acute necrotizing encephalitis in an adult using high-dose oseltamivir and methylprednisolone: case report and literature review. Open Forum Infect Dis 2017;4:ofx145.
– reference: 12) Sell K, Storch K, Hahn G, et al. Variable clinical course in acute necrotizing encephalopathy and identification of a novel RANBP2 mutation. Brain Dev 2016;38:777-780.
– reference: 4) Iijima H, Wakasugi K, Ayabe M, et al. A case of adult influenza A virus-associated encephalitis: magnetic resonance imaging findings. J Neuroimaging 2002;12:273-275.
– reference: 6) Lee YJ, Smith DS, Rao VA, et al. Fatal H1N1-related acute necrotizing encephalopathy in an adult. Case Rep Crit Care 2011;2011:562516.
– reference: 15) Mizuguchi M, Abe J, Mikkaichi K, et al. Acute necrotising encephalopathy of childhood: a new syndrome presenting with multifocal, symmetric brain lesions. J Neurol Neurosurg Psychiatry 1995;58:555-561.
– reference: 9) Ochi N, Takahashi K, Yamane H, et al. Acute necrotizing encephalopathy in an adult with influenza A infection. Ther Clin Risk Manag 2018;14:753-756.
– reference: 1) Morita A, Ishihara M, Kamei S, et al. Nationwide survey of influenza-associated acute encephalopathy in Japanese adults. J Neurol Sci 2019;399:101-107.
– reference: 11) Neilson DE. The interplay of infection and genetics in acute necrotizing encephalopathy. Curr Opin Pediatr 2010;22:751-757.
– reference: 10) Fernandez-Blazquez A, Castanon-Apilanez M, Alvarez-Arguelles ME, et al. Neuroinvasion of influenza A/H3N2: a fatal case in an immunocompetent adult. J Neurovirol 2019;25:275-279.
– reference: 2) Davis LE, Koster F, Cawthon A. Neurologic aspects of influenza viruses. Handb Clin Neurol 2014;123:619-645.
SSID ssib000959814
ssib058494234
ssib002821941
ssib000940416
ssib002484599
ssib005879791
ssj0060813
Score 2.2272916
Snippet ...
SourceID jstage
SourceType Publisher
StartPage 157
SubjectTerms インフルエンザウイルス感染
急性壊死性脳症
成人例
Title インフルエンザウイルス感染に伴った急性壊死性脳症の2成人例
URI https://www.jstage.jst.go.jp/article/clinicalneurol/60/2/60_cn-001381/_article/-char/ja
Volume 60
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX 臨床神経学, 2020, Vol.60(2), pp.157-161
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrR1Na9RANNQK4kX8xG96cI6pyWQmM3Oc7KYWpYLQQm8hySbIIquU9uKpuy0oehFEPPZQv6DopSJYxT-TunrxP_jeJNlmi4oWYRnezrz35s17k8ybycwby7pCnY6bZk5mSx7nNkZ_sWWcZTb1MicVcexxhaeR5276swvs-iJfnDj0o7FraWU5mU7v__JcyUGsCnlgVzwl-w-WHTGFDIDBvpCChSH9KxuT0COSEs0M4JHAqwDFK0AHNY4cx6Ek8Osifz-fEVWgSOgTyYiaQQBSVZK7BoeRoEUCVufURSWydIjmNSBIyBFBaszRbRIEjSKJVaBggihBpKgZhtQgSaIcU5nGHwIhkUHTrTYshGkkRxysRmD1KkQg4ES2jARtaG3dx0ioUCQ9Y0pAbI39DVmBKJqaXEa0RjxQigybhCAUNhx00sJqDSE3f9qGQ4sotocvEV8rU-KjdAYfIJC2IQ-0TBoGwLZNlFuzrYhBO2iJ5kINdUYPlaESlc5RkNYfdFDZTumxUUvBoGSuYIYxuxyocGaEB4ObI1l5M0P1xNLGsOSWQcArD8ctw9_vHzy5rzAYb30i18RTvTOd9mzzNdvdcxhG2zirjh-Nk0S-E1FM0l5UkkYjxNvxUtSF6cxhKoSLO3Bv3GrMBhRzxj6CK65k4yM_ZZJxNbZa4DaPYXMplNgL_QSutYLJAqsdMx-839HFiqjOcmMfNvvq7xoNfmkXZmn1Dk_jdM4ft45Vs8UpXTbshDXRjU9aR-aq_TCnrIVi8KJY2y7WnhVrW8XgDcKDD8XglcmHnI_D9Y3hxtOiv7X7-X3R3yz6G8PVl8PV1183Hw3ffgLg-_r2t-cPiv47Onz4ZHdnZ_fL49PWwkw435q1q4tS7C7eJ2F3aIbv4ixPcseVmcolZ77MaCfJuchTmSoW40lpB7yJmMmEs07uxank0k19N4u9M9Zk724vO2tNiZTmmZMwhknq54mSVOAaiI-BJIV7zrpWKiS6V0bDiQ7aCc7_N04XrKP4vJULoxetyeWllewSTBWWk8umg_0EXe3rkA
linkProvider Colorado Alliance of Research Libraries
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E3%82%A4%E3%83%B3%E3%83%95%E3%83%AB%E3%82%A8%E3%83%B3%E3%82%B6%E3%82%A6%E3%82%A4%E3%83%AB%E3%82%B9%E6%84%9F%E6%9F%93%E3%81%AB%E4%BC%B4%E3%81%A3%E3%81%9F%E6%80%A5%E6%80%A7%E5%A3%8A%E6%AD%BB%E6%80%A7%E8%84%B3%E7%97%87%E3%81%AE2%E6%88%90%E4%BA%BA%E4%BE%8B&rft.jtitle=%E8%87%A8%E5%BA%8A%E7%A5%9E%E7%B5%8C%E5%AD%A6&rft.au=%E9%A3%AF%E5%A1%9A%2C+%E8%B3%A2%E5%A4%AA%E9%83%8E&rft.au=%E9%88%B4%E6%9C%A8%2C+%E5%9C%AD%E8%BC%94&rft.au=%E8%88%A9%E8%B6%8A%2C+%E6%85%B6&rft.au=%E4%B8%AD%E6%9D%91%2C+%E5%88%A9%E7%94%9F&rft.date=2020&rft.pub=%E6%97%A5%E6%9C%AC%E7%A5%9E%E7%B5%8C%E5%AD%A6%E4%BC%9A&rft.issn=0009-918X&rft.eissn=1882-0654&rft.volume=60&rft.issue=2&rft.spage=157&rft.epage=161&rft_id=info:doi/10.5692%2Fclinicalneurol.cn-001381&rft.externalDocID=article_clinicalneurol_60_2_60_cn_001381_article_char_ja
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0009-918X&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0009-918X&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0009-918X&client=summon