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タカナシ ジユンイチ
TAKANASHI Jiyun'ichi
髙梨 潤一 所属 医学部 医学科（附属八千代医療センター） 職種 教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | National study on pediatric acute encephalopathy in Japan (April 2020 to October 2023): Insights from the third study |
| 掲載誌名 | 正式名：Brain & development 略 称：Brain Dev ISSNコード：03877604/18727131 |
| 掲載区分 | 国外 |
| 出版社 | Elsevier B.V. |
| 巻・号・頁 | 47(4),pp.104387 |
| 著者・共著者 | Omata Taku†*, Sakuma Hiroshi, Nagase Hiroaki, Abe Yuichi, Kuki Ichiro, Okumura Akihisa, Maegaki Yoshihiro, Murayama Kei, Sakai Yasunari, Hoshino Ai, Mizuguchi Masashi, Takanashi Jun-ichi |
| 担当区分 | 最終著者 |
| 発行年月 | 2025/08 |
| 概要 | BACKGROUND:Previous national studies of acute encephalopathy in Japan were conducted in 2007-2010 and 2014-2017. In this third study (April 1, 2020-October 31, 2023), spanning the coronavirus disease 2019 (COVID-19) outbreak, we compared results to assess trends in pediatric viral infections and therapeutic practices.METHODS:Questionnaires were sent to 430 hospitals of the Japanese Pediatric Society, yielding 241 responses and 1197 cases. A secondary survey to 151 facilities received 110 responses (72.8 %), identifying 622 eligible patients (604 for treatment, 544 for outcome analysis). Data on patient background, syndrome classification, causative virus, treatment, and prognosis were collected.RESULTS:Among 622 cases (54.6 % boys), the highest incidence was in 1-year-olds, with case numbers peaking during COVID-19 and influenza outbreaks. The frequency of clinical syndromes was: acute encephalopathy with biphasic seizures and late reduced diffusion, 35.1 %; clinically mild encephalitis/encephalopathy with a reversible splenial lesion, 17.8 %; hemorrhagic shock and encephalopathy syndrome (HSES), 6.9 %; acute encephalitis with refractory, repetitive partial seizures, 3.7 %; acute fulminant cerebral edema (AFCE), 2.2 %; acute necrotizing encephalopathy, 1.6 %; and unclassifiable, 31.4 %. Notably, the combined HSES/AFCE rate increased from 1.9 % in the 2014-2017 survey to 9.1 %, likely due to enhanced diagnosis and COVID-19 impact. Pathogens were exanthem subitum (16.1 %), severe acute respiratory syndrome coronavirus 2 (15.9 %), and influenza (7.7 %). Treatments included steroid pulse therapy (68.9 %), mitochondrial cocktails (42.5 %), and targeted temperature management (31.0 %).CONCLUSION:This study provides a comprehensive overview of pediatric acute encephalopathy during COVID-19 outbreaks, shows increases in the incidence of HSES/AFCE, and presents current treatment. |
| DOI | 10.1016/j.braindev.2025.104387 |
| PMID | 40570505 |