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1.
J Infect Chemother ; 18(6): 827-31, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22572852

RESUMO

Respiratory syncytial virus (RSV) infection in children can be associated with acute encephalopathy. However, the roles of cytokines in the cerebrospinal fluid (CSF) of such patients remain unevaluated. In this study, a profile of 17 cytokines was determined for eight RSV-infected children with neurological complications. In one patient with high levels of 13 cytokines, a cytokine storm was considered to have occurred. Interleukin (IL)-6, IL-8, monocyte chemoattractant protein (MCP)-1, and macrophage inflammatory protein (MIP)-1ß levels were also high in other patients. These data suggest that chemokines in CSF play roles in neurological complications in RSV-infected children.


Assuntos
Viroses do Sistema Nervoso Central/líquido cefalorraquidiano , Quimiocinas/biossíntese , Quimiocinas/líquido cefalorraquidiano , Infecções por Vírus Respiratório Sincicial/líquido cefalorraquidiano , Vírus Sinciciais Respiratórios/isolamento & purificação , Viroses do Sistema Nervoso Central/virologia , Quimiocinas/genética , Pré-Escolar , Feminino , Genoma Viral , Humanos , Lactente , Recém-Nascido , Masculino , RNA Viral/líquido cefalorraquidiano , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/genética
3.
Pediatr Int ; 54(1): 86-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22136601

RESUMO

BACKGROUND: Children infected with rotavirus often show increased levels of transaminase, and symptoms are characterized by white stool, similar to biliary atresia. Rotavirus infections are also sporadically accompanied with convulsions, encephalopathy and Reye syndrome. The aim of the present study was therefore to investigate transaminase and interleukin (IL)-6 levels in rotavirus infection, in order to better understand their clinical significance. METHODS: Results of liver function tests, mainly the elevation of transaminase and IL-6 in rotavirus gastroenteritis with or without convulsions, were evaluated. RESULTS: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were high in 23 of 26 samples (88.5%), and in three of 26 samples (11.5%), respectively. No significant differences in liver function tests could be found between the groups with or without convulsions. Three patients whose direct bilirubin levels were above the upper normal limit were all classified into the group without convulsions. Spearman's correlation coefficient was 0.89 between increasing AST levels and IL-6 levels. CONCLUSION: Rotavirus infection is occasionally accompanied with hepatitis, but only in a mild form, and does not correlate with neurological complications. High levels of transaminase might reflect high IL-6.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Gastroenterite/virologia , Interleucina-6/sangue , Infecções por Rotavirus/sangue , Convulsões/sangue , Pré-Escolar , Feminino , Gastroenterite/sangue , Humanos , Lactente , Testes de Função Hepática , Masculino , Estudos Retrospectivos , Infecções por Rotavirus/complicações , Convulsões/virologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-22084613

RESUMO

This report concerns a 12-year-old male with intractable seizures over a long period. The case fulfilled the diagnostic criteria for nonherpetic acute limbic encephalitis. He had frequent convulsions starting with a partial seizure at the left angle of the mouth and progressing to secondary generalized seizures. He was treated with several anticonvulsants, combined with methylprednisolone and γ-globulin under mechanical ventilation. However, his convulsions reappeared after tapering of the barbiturate. His magnetic resonance imaging showed a high intensity area in the hippocampus by FLAIR and diffusion. After five months he recovered without serious sequelae. Virological studies, including for herpes simplex virus, were all negative. He was transiently positive for antiglutamate receptor antibodies in cerebrospinal fluid and serum.

6.
Pediatr Int ; 53(2): 159-61, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21501304

RESUMO

BACKGROUND: Neuromuscular disorders can be the cause of sudden death of infants because of their weakness and gastroesophageal reflux (GER). METHODS: Muscle biopsy and genetic studies were performed by usual method. RESULTS: In this report four cases of infants with neuromuscular disorders (two cases of congenital myopathy and two cases of spinal muscular atrophy) who had unexpected cardiopulmonary arrest on arrival (CPAOA) are presented. Two of the cases did not show any symptoms, such as muscle weakness prior to CPAOA. The diagnosis was based on the results of the muscle biopsy and genetic examination. CONCLUSION: These results suggest that sudden infant death caused by neuromuscular disorders should be considered.


Assuntos
Parada Cardíaca/etiologia , Doenças Musculares/complicações , Atrofias Musculares Espinais da Infância/complicações , Morte Súbita do Lactente/etiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Miopatias da Nemalina/complicações , Miopatias Congênitas Estruturais
7.
J Infect Chemother ; 17(4): 538-40, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21229284

RESUMO

We report prolonged valganciclovir (VGCV) treatment of a symptomatic cytomegalovirus infection case. Automated auditory brainstem evoked response performed at 5 days of age revealed severe hearing impairment. Cranial magnetic resonance (MR) imaging at 11 days of age showed abnormal findings. At 5 weeks of age, VGCV was started. The viral load in blood cells, plasma, and urine decreased during the 6-week treatment. Because of improvement of hearing level and no adverse effects, VGCV was restarted for an additional 6 weeks. Neither the patient's hearing impairment nor results of cranial MR imaging have become worse in 6 months. It is crucial to gather information from as many cases as possible treated with VGCV to establish a standard protocol for VGCV treatment.


Assuntos
Antivirais/administração & dosagem , Infecções por Citomegalovirus/tratamento farmacológico , Ganciclovir/análogos & derivados , Doenças do Recém-Nascido/tratamento farmacológico , Encéfalo/diagnóstico por imagem , Citomegalovirus/genética , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/diagnóstico por imagem , Infecções por Citomegalovirus/virologia , DNA Viral/sangue , DNA Viral/urina , Potenciais Evocados Auditivos do Tronco Encefálico , Ganciclovir/administração & dosagem , Perda Auditiva/virologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico por imagem , Doenças do Recém-Nascido/virologia , Imageamento por Ressonância Magnética , Masculino , Radiografia , Valganciclovir , Carga Viral
9.
Pediatr Neurol ; 42(6): 409-12, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20472192

RESUMO

This study sought to determine diurnal variations in febrile convulsions, and to investigate whether such variations influenced the severity of febrile convulsions. The study involved 326 children, between ages 6 months and 6 years, with simple febrile convulsions. Data were collected systematically by interviewing witnesses within the week after febrile convulsions occurred. The frequency of febrile convulsions was approximately 5 times greater in the evening than in early morning. An adaptation curve revealed that the maximum occurrence of febrile convulsions was at 4:00 pm (4:00-4:59 pm), and the minimum, at 4:00 am (4:00-4:59 am), similar to the pattern of human body temperature. Temperature and seizure duration did not differ significantly between high-frequency and low-frequency zones (2:00-7:00 pm and 2:00-7:00 am, respectively) (high-frequency zone vs low-frequency zone, 39.20 degrees C (S.D., 0.68 degrees C) vs 39.22 degrees C (S.D., 0.64 degrees C) and 3.82 minutes (S.D., 5.27 minutes) vs 3.14 minutes (S.D., 3.19 minutes)). These results suggest that the circadian rhythm does not change seizure propensity, but its hourly occurrence is attributable to an elevation in the temperature set point in the 24-hour period. The prevention of recurrent febrile convulsions by rectal administration of anticonvulsants in high-frequency zones would be clinically helpful.


Assuntos
Temperatura Corporal/fisiologia , Ritmo Circadiano/fisiologia , Convulsões Febris/fisiopatologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Seleção de Pacientes , Inquéritos e Questionários
11.
Int J Neurosci ; 120(2): 99-103, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20199200

RESUMO

In order to better understand enteroviral encephalitis we investigated the clinical symptoms and several disease markers. Between 2000 and 2005 eight patients aged between 9 months and 5 years were admitted to our hospital with one case having sequela. Glutamic oxaloacetic transaminase (GOT), serum IL-6, and ferritin were elevated in most of the cases. Their IL-6 and diacron-reactive oxygen metabolites (d-ROM) in cerebral spinal fluid (CSF) were also high (86%). However, pleocytosis and high protein levels in CSF were rarely found. In viral loads of the first CSF, there were no differences between the patient with sequela and the ones without sequela. However, anti-glutamate receptor IgMdelta2 was only detected in the CSF of the patient with sequela. These findings suggest that the immunological phenomenon is more closely related to the development of sequela related to enteroviral encephalitis than other disease markers, such as inflammatory cytokine, free radicals, and viral loads. Therefore, a specific therapy against immunological status might decrease the sequela; however, further research is necessary to confirm this.


Assuntos
Anticorpos/imunologia , Encefalite Viral/imunologia , Infecções por Enterovirus/imunologia , Receptores de Glutamato/imunologia , Anticorpos/líquido cefalorraquidiano , Aspartato Aminotransferases/sangue , Criança , Eletroencefalografia , Encefalite Viral/líquido cefalorraquidiano , Infecções por Enterovirus/líquido cefalorraquidiano , Feminino , Ferritinas/sangue , Humanos , Imunoglobulina M/líquido cefalorraquidiano , Interleucina-6/sangue , Masculino , Estresse Oxidativo , RNA Viral/genética , Espécies Reativas de Oxigênio/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Convulsões/etiologia , Carga Viral
12.
Pediatr Int ; 52(2): 171-4, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19519671

RESUMO

BACKGROUND: In recent years an increase has been seen in the number of patients with severe atopic dermatitis (AD) accompanied with generalized typical eruptions. Some markers indicating the severity of the disease and symptom changes are very useful, and therefore the purpose of the present study was to investigate serum lactate dehydrogenase (LDH) as such a marker. METHODS: A total of 58 children with AD were enrolled. The severity of the disease was graded on the basis of the extent of eruptions and the severity of atopic symptoms. The fraction of serum LDH, number of eosinocytes in the peripheral blood, and serum IgE levels were also determined. RESULTS AND CONCLUSION: There was a close correlation between the severity of cutaneous symptoms and serum LDH activity, and between severity and eosinocyte count, but no relationship was seen between serum IgE levels and severity of the disease. The aforementioned factors were determined in a time-related way. As the patients' condition improved, serum LDH activity tended to decline, but there were no consistent changes in eosinocyte count in the peripheral blood or serum IgE level. On LDH isozyme the levels of LDH4 and LDH5 were high. Tissue showed high LDH activity, especially in epidermides. These results suggest that serum LDH activity is a useful marker.


Assuntos
Dermatite Atópica/sangue , L-Lactato Desidrogenase/sangue , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino
14.
Tohoku J Exp Med ; 218(1): 1-3, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19398866

RESUMO

Severe combined immunodeficiency (SCID) is an inherited disease with profoundly defective T cells, B cells, and NK cells. X-linked severe combined immunodeficiency (X-SCID) is its most common form. In this report, we describe a 4-month old male with X-SCID who also showed opisthotonic posturing. Opisthotonus represents abnormal motor posturing and is defined as the posturing, in which the neck and back are arched posteriorly. The patient was referred to our hospital with liver dysfunction, respiratory distress, anal abscess, poor feeding and wasting; the patient appeared to suffer from severe and persistent infections. In fact, circulating T cells were not detectable, despite that the number of B cells was maintained in the normal ranges. Diagnosis of X-SCID was established by DNA analysis of the interleukin (IL)-2 receptor gamma chain gene; namely, we detected the novel mutation within exon 2 (221 C-->A), which leads to the substitution of tyrosine codon for stop codon (Y69stop). Computed tomography of the brain revealed mild atrophy, but no hemorrhage and no malformation. There were no pathological findings in the cerebrospinal fluid. Thus, the cause of opisthotonic posturing remains unknown. The patient died due to severe infection at the age of 7 months. It remains to be investigated to clarify the relationship between the mutation and clinical manifestations. In conclusion, we have identified the novel mutation in the IL-2 receptor gamma chain gene, which is associated with X-SCID. Furthermore, this is the first report that describes the patient with X-SCID accompanying opisthotonus.


Assuntos
Distonia , Subunidade gama Comum de Receptores de Interleucina/genética , Doenças por Imunodeficiência Combinada Ligada ao Cromossomo X , Análise Mutacional de DNA , Distonia/genética , Distonia/imunologia , Humanos , Lactente , Masculino , Mutação de Sentido Incorreto , Doenças por Imunodeficiência Combinada Ligada ao Cromossomo X/genética , Doenças por Imunodeficiência Combinada Ligada ao Cromossomo X/imunologia
15.
Int J Rheum Dis ; 12(4): 307-10, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20374367

RESUMO

OBJECTIVE: Kawasaki disease (KD) is a systemic vasculitis in childhood; its etiology is unknown. The possibility that KD is an infectious disease has been discussed and investigated for decades, in light of the implication that infections are involved in the pathogenesis of KD. Young children rely on their innate immune system for protection against virus and micro-organisms. Human mannose binding lectin (MBL) is a C-type serum lectin synthesized by the liver as an acute phase protein and it plays an important role in the innate immune system. Here, we investigate the relationship between the MBL gene polymorphisms and the occurrence of KD in the Japanese population. METHOD: The frequencies of the genotypes, defined as mutations in codons 52, 54 and 57, and the functional promoter variants of the MBL were determined in 45 patients with KD. RESULTS: The MBL codon-54 polymorphism frequency of heterozygote (GGC/GAC) and promoter variants were significantly higher in the KD group than that in the control group (P < 0.05). Neither group showed codon 52 nor 57 polymorphisms. CONCLUSION: It is possible that mutations of the MBL gene might be related to the trigger of the pathogenesis of Kawasaki disease.


Assuntos
Predisposição Genética para Doença , Imunidade Inata/genética , Lectina de Ligação a Manose/genética , Síndrome de Linfonodos Mucocutâneos/genética , Polimorfismo Genético , Criança , Pré-Escolar , Análise Mutacional de DNA , Feminino , Genótipo , Humanos , Lactente , Masculino , Síndrome de Linfonodos Mucocutâneos/imunologia
16.
Clin Med Case Rep ; 2: 27-30, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-24179369

RESUMO

Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare autoimmune disease and the pathogenesis is still unknown. We report a case of TINU syndrome with high ASLO titer. Uveitis improved and urine ß2-MG normalized with low dose systemic predonisolone and cyclosporin A. The high ASLO titer in early phase suggested that streptococcal infection might have triggered TINU syndrome. Lymphocyte phenotypes normalized after treatment with low dose systemic predonisolone and cyclosporin A.

17.
Pediatr Int ; 50(3): 284-6, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18533937

RESUMO

BACKGROUND: In the pathology of autoimmune hepatitis the immunity mechanism of T-helper 1 (Th1) and Th2 cells was recently evaluated. The purpose of the present study was to measure the mRNA levels in peripheral mononuclear cells and serum cytokines obtained from children with autoimmune hepatitis for a better understanding of the mechanism. METHODS: Twenty-five patients with autoimmune hepatitis and seven controls were enrolled. mRNA levels in peripheral mononuclear cells and serum cytokines were measured using real-time polymerase chain reaction and immunoassay. RESULTS: Serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) were rarely detected. In contrast the IFN-gamma/beta-actin mRNA levels were high. CONCLUSION: Autoimmune hepatitis is a Th1-predominant state, therefore immune modulation therapies that target the control of Th1 cytokines should be used.


Assuntos
Expressão Gênica , Hepatite Autoimune/genética , Interferon gama/genética , Interleucina-4/genética , RNA Mensageiro/genética , Células Th1/metabolismo , Células Th2/metabolismo , Actinas/biossíntese , Actinas/genética , Adolescente , Adulto , Biomarcadores/sangue , Criança , Pré-Escolar , Hepatite Autoimune/sangue , Hepatite Autoimune/imunologia , Humanos , Imunoensaio , Interferon gama/biossíntese , Interleucina-4/biossíntese , Reação em Cadeia da Polimerase , Prognóstico , Células Th1/imunologia , Células Th2/imunologia
18.
J Clin Lab Anal ; 22(3): 216-9, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18484653

RESUMO

For a better understanding of the role of the viral load, free radicals, and cytokines in viral meningitis, we surveyed cerebrospinal fluid (CSF) obtained from patients below 1 year of age who showed positive for enterovirus. In their first examinations interleukin (IL)-6 and free radicals increased whereas pleocytosis was rarely observed. IL-6 decreased within the short period. Viral loads and free radicals increased simultaneously. IL-6 and free radicals of CSF are helpful for diagnosis and treatment of viral meningitis at an early stage.


Assuntos
Infecções por Enterovirus/líquido cefalorraquidiano , Meningite Viral/líquido cefalorraquidiano , Carga Viral , Enterovirus/fisiologia , Infecções por Enterovirus/induzido quimicamente , Infecções por Enterovirus/virologia , Feminino , Radicais Livres/líquido cefalorraquidiano , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Lactente , Recém-Nascido , Interleucina-6/líquido cefalorraquidiano , Masculino , Meningite Viral/diagnóstico , Meningite Viral/virologia , RNA Viral/líquido cefalorraquidiano , Resultado do Tratamento
19.
Neurochem Res ; 33(6): 1017-23, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18080188

RESUMO

The cause of influenza to the brain was investigated using the A/NWS/33 influenza virus infected BALB/c mouse model. NOS-2 mRNA levels in the infected mouse brain was greater than in control mice in all brain regions examined, particularly in the olfactory bulb and hippocampus by 1 day p.i. On the contrary, no differences in NOS-1 or NOS-3 mRNA levels were found between infected and control mice. There was also a marked increase in the levels of metabolites of nitric oxide in the olfactory bulb and hippocampus. Immunohistochemistry showed positive staining for anti-NOS-2 primarily in the hippocampus of infected mice. Further, anti-NOS-2 and GFAP staining was mostly found around capillary blood vessels of the hippocampus starting early in the course of the disease. These results indicate that the NWS enhances the activation of astrocytes and NOS-2 expression which in turn enhances NO production and the expansion of capillary blood vessels.


Assuntos
Encéfalo/metabolismo , Proteína Glial Fibrilar Ácida/metabolismo , Vírus da Influenza A , Óxido Nítrico/metabolismo , Infecções por Orthomyxoviridae/metabolismo , Animais , Peso Corporal , Encéfalo/citologia , Proteína Glial Fibrilar Ácida/genética , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Óxido Nítrico Sintase Tipo II/genética , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III
20.
Clin Med Case Rep ; 1: 33-5, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-24179342

RESUMO

We report a four-year-old Japanese girl with hyper IgD and periodic fever syndrome. There is a first report of hyper IgD syndrome (HIDS) of which the genomic study was done in Japan. In this report a girl complained of periodic fever and abdominal symptoms accompanied with high levels of mevalonic acid in urine and serum. She has been well controlled by non-steroidal anti-inflammatory drugs (NSAIDs) for 3 years.

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