Adenovirus-induced Acute Necrotizing Encephalopathy in a Previously Healthy Infant- A case report

Carla Chikhani; Hmaimess Ghassan; Hicham Mansour; Soha Ghanem; Dany  Hamod; Yolla Nassif; Marwa Masri

doi:10.36013/ijipem.v8i.103

Carla Chikhani Saint George Hospital University Medical Center
Hmaimess Ghassan Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.
Hicham Mansour Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.
Soha Ghanem Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.
Dany Hamod Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.
Yolla Nassif Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.
Marwa Masri â€“ Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

DOI: https://doi.org/10.36013/ijipem.v8i.103

Keywords: Acute necrotizing encephalopathy of childhood (ANEC), Adenovirus, seizure, Lebanon, hyperammonemia, mitochondrial disease

Abstract

Acute necrotizing encephalopathy of childhood has been described as a rare entity that usually affects immunocompetent infants and children, mainly in East Asia, and typically after a viral infection. We describe the case of an 8-month-old, previously healthy Lebanese boy, who presented with fever and seizures and was found to have acute necrotizing encephalopathy with Adenovirus detected in the CSF. The clinical presentation and laboratory and radiological findings are described, and the outcomes are discussed.

Author Biographies

Hmaimess Ghassan, Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

Neurology

Hicham Mansour, Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

Neurology and Metabolic Diseases

Soha Ghanem, Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

Infectious Diseases

Dany Hamod, Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

Reanimator

Yolla Nassif, Department of Pediatrics, Saint Georges University Medical Center, Beirut, Lebanon.

Reanimator

References

StevanoviÄ‡ V, BaruÅ¡iÄ‡ Z, ViÅ¡koviÄ‡ K, Rode OÄ, TeÅ¡oviÄ‡ G. Acute necrotizing encephalopathy of childhood associated with human herpes virus 6 in Croatia. Neurol Sci. 2019;40(3):639-41. doi: 10.1007/s10072-018-3623-8. DOI: https://doi.org/10.1007/s10072-018-3623-8

Mittal A, Kuntar S, Vaswani ND, Kaushik JS. Acute necrotizing encephalopathy of childhood associated with human Parvovirus B19 infection. Indian J Pediatr. 2020;87(8):648-649doi: 10.1007/s12098-020-03224-z. DOI: https://doi.org/10.1007/s12098-020-03224-z

Ito Y, Ichiyama T, Kimura H, et al. Detection of influenza virus RNA by reverse transcription-PCR and proinflammatory cytokines in influenza-virus-associated encephalopathy. J Med Virol. 1999;58(4):420-5.. doi: 10.1002/(sici)1096-9071(199908)58:4<420::aid-jmv16>3.0.co;2-t. PMID: 10421411. DOI: https://doi.org/10.1002/(SICI)1096-9071(199908)58:4<420::AID-JMV16>3.0.CO;2-T

Saied A, Elsaid N, Belal T, Ahmed Z, Sherif F. Acute necrotizing encephalopathy in Egyptian childrenâ€“case Series. Egypt J Crit Care Med.. 2020;7(2 and 3):68-73. doi: 10.1097/EJ9.0000000000000011

Bashiri FA, Al Johani S, Hamad MH, et al. Acute necrotizing encephalopathy of childhood: A multicenter experience in Saudi Arabia. Front Pediatr [Internet]. 2020 Oct 9 [cited 2023 Mar 8];8. Available from: https://www.frontiersin.org/articles/10.3389/fped.2020.00526/full. doi: 10.3389/fped.2020.00526. DOI: https://doi.org/10.3389/fped.2020.00526

Hosseini SA, Tabatabaei FS, Molseghi MH, et al. A rare case report of acute necrotizing encephalopathy of childhood. Iran J Child Neurol. 2020 Winter;14(1):133-137.

Sakrani N, Almazrouei S, Mohan S, Ramsi M. Adenovirus as a rare cause of acute necrotizing encephalitis. BMJ Case Rep. 2019 Dec 3;12(12):e232338. doi: 10.1136/bar-2019-232338. doi: 10.1136/bcr-2019-232338. DOI: https://doi.org/10.1136/bcr-2019-232338

Schwartz KL, Richardson SE, MacGregor D, Mahant S, Raghuram K, Bitnun A. Adenovirus-associated central nervous system disease in children. J Pediatr. 2019;205:130-137. doi: 10.1016/j.jpeds.2018.09.036. DOI: https://doi.org/10.1016/j.jpeds.2018.09.036

Mizuguchi M. Acute necrotizing encephalopathy of childhood: a novel form of acute encephalopathy prevalent in Japan and Taiwan. Brain Dev. 1997;19(2):81-92. doi: 10.1016/s0387-7604(96)00063-0.. DOI: https://doi.org/10.1016/S0387-7604(96)00063-0

Mastroyianni SD, Gionnis D, Voudris K, Skardoutsou A, Mizuguchi M. Acute necrotizing encephalopathy of childhood in Non-Asian patients: Report of three cases and literature review. J Child Neurol [Internet]. 2006 Oct [cited 2023 Mar 8];21(10):872-9. Available from: https://journals.sagepub.com/doi/10.1177/08830738060210101401. doi: 10.1177/08830738060210101401. DOI: https://doi.org/10.1177/08830738060210101401

Okumura A, Mizuguchi M, Kidokoro H, Tanaka M, Abe S, Hosoya M, Aiba H, Maegaki Y, Yamamoto H, Tanabe T, Noda E, Imataka G, Kurahashi Het al. Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin. Brain Dev [Internet]. 2009 Mar [cited 2023 Mar 8];31(3):221-7. doi: 10.1016/j.braindev.2008.03.005 DOI: https://doi.org/10.1016/j.braindev.2008.03.005

Loni R, Rajebhosale P, Bhateja P, Konde S. Acute necrotizing encephalopathy of childhood: A case

report. Indian J Child Health [Internet]. 2020 Jun 25 [cited 2023 Mar 8];07(06):280-2. doi: 10.32677/ijch.2020.v07.i06.010 DOI: https://doi.org/10.32677/IJCH.2020.v07.i06.010

Wong AM, Simon EM, Zimmerman RA, Wang HS, Toh CH, Ng SH. Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol. 2006 Oct;27(9):1919-23.