TY - JOUR
T1 - Exanthem Subitum-Associated Encephalitis
T2 - Nationwide Survey in Japan
AU - Yoshikawa, Tetsushi
AU - Ohashi, Masahiro
AU - Miyake, Fumi
AU - Fujita, Ayano
AU - Usui, Chie
AU - Sugata, Ken
AU - Suga, Sadao
AU - Hashimoto, Shuji
AU - Asano, Yoshizo
N1 - Funding Information:
This work was supported in part by a Grant-in-Aid for the 21st Century Centers of Excellence Program of Medicine and by the Open Research Center, both at Fujita Health University, and by the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The authors have no commercial or other associations that might pose a conflict of interest.
PY - 2009/11
Y1 - 2009/11
N2 - We sought to clarify clinical features of exanthem subitum associated-encephalitis/encephalopathy, generally caused by primary human herpesvirus-6 infection in Japan. A two-part questionnaire was sent to hospitals between January 2003-December 2004. Of 3357 questionnaires, 2357 (70.2%) were returned, and 2293 (68.3%) were eligible for analysis. Eighty-six cases of exanthem subitum-associated encephalitis/encephalopathy were reported. Seventy-seven (89.5%) of 86 patients were diagnosed with human herpesvirus-6 infection by virologic examination. Although 41 (50.6%) of 81 patients had no sequelae, 38 (46.9%) had neurologic sequelae. Moreover, two fatal cases (2.5%) were reported. Pleocytosis was evident in only 4 (7.5%) of 53 patients, and cerebrospinal fluid protein levels were within normal range (23.4 ± 14.6 mg/dL S.D.) in all patients. Human herpesvirus-6 DNA was detected in 21 (53.8%) of 39 patients. Abnormal computed tomography findings were a predictor of neurologic sequelae (P = 0.0097). As a consequence of this survey, we estimate that 61.9 cases of exanthem subitum-associated encephalitis occur every year. The disease prognosis was unexpectedly poor.
AB - We sought to clarify clinical features of exanthem subitum associated-encephalitis/encephalopathy, generally caused by primary human herpesvirus-6 infection in Japan. A two-part questionnaire was sent to hospitals between January 2003-December 2004. Of 3357 questionnaires, 2357 (70.2%) were returned, and 2293 (68.3%) were eligible for analysis. Eighty-six cases of exanthem subitum-associated encephalitis/encephalopathy were reported. Seventy-seven (89.5%) of 86 patients were diagnosed with human herpesvirus-6 infection by virologic examination. Although 41 (50.6%) of 81 patients had no sequelae, 38 (46.9%) had neurologic sequelae. Moreover, two fatal cases (2.5%) were reported. Pleocytosis was evident in only 4 (7.5%) of 53 patients, and cerebrospinal fluid protein levels were within normal range (23.4 ± 14.6 mg/dL S.D.) in all patients. Human herpesvirus-6 DNA was detected in 21 (53.8%) of 39 patients. Abnormal computed tomography findings were a predictor of neurologic sequelae (P = 0.0097). As a consequence of this survey, we estimate that 61.9 cases of exanthem subitum-associated encephalitis occur every year. The disease prognosis was unexpectedly poor.
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U2 - 10.1016/j.pediatrneurol.2009.05.012
DO - 10.1016/j.pediatrneurol.2009.05.012
M3 - Article
C2 - 19818937
AN - SCOPUS:70349759482
SN - 0887-8994
VL - 41
SP - 353
EP - 358
JO - Pediatric Neurology
JF - Pediatric Neurology
IS - 5
ER -
