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Accession number;02A0168954
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| Title;Pathological Findings of Two Patients with Influenza-associated Encephalopathy Who Died with a Rapid Fulminant Course. |
| Author;
TOGASHI TAKEHIRO
(Sapporo City Hosp.)
MATSUZONO YOSHIHIRO
(Abashiri Kosei Hosp.)
TAKEKOSHI YASURO
(Chitose Munic. Gen. Hosp.)
NAGANO NAOKO
(Asahikawa City Hospital)
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Journal Title;Journal of the Japan Pediatric Society
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Journal Code:F0896A
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ISSN:0001-6543
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VOL.106;NO.1;PAGE.76-80(2002)
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| Figure&Table&Reference;FIG.8, REF.8 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Post-mortem examinations were performed pathologically and virologically in two patients with influenza-associated encephalopathy who died with a rapid and fulminant course. Disseminated edema, vascular damage with subsequent leakage of plasma protein and intravascular formation of thrombus were observed in the upper part of the spinal cord and in the brain stem. Interstitial pneumonia was observed in both cases. Intravascular thrombus formation in the bilateral lungs and intestinal destruction were observed in one case. Influenza virus genome, H3, was detected by PCR in a CSF sample of one case and influenza-A specific antigen was detected using a monoclonal antibody against NP polypeptide in the bronchial epithelial cells of another case. Irrespective of the pathological changes in spinal cord and brain stem, no virus, no virus antigens, and no virus genome were detected in these materials. Cytokines such as IL-6 and TNF-.ALPHA. were markedly elevated in CSF and serum samples of one case. These findings strongly suggest damage of the endothelial cells of systemic vessles and destruction of the blood-brain barrier with the activation of the coagulation system. This must have resulted in the leakage of plasma protein and the intravascular formation of thrombus in the brain, and consequently, the patients with this disease, with or without convulsion, fell into coma along with haemorrhagic diathesis. (author abst.) |
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