An Unusual Autopsy Case of Cytokine Storm–Derived Influenza–Associated Encephalopathy Without Typical Histopathological Findings: Autopsy Case Report. (March 2015)

• Record Type: Journal Article
• Authors: Nara, Akina; Nagai, Hisashi; Yamaguchi, Rutsuko; Yoshida, Ken-ichi; Iwase, Hirotaro; Mizuguchi, Masashi
• Is Part Of: American journal of forensic medicine & pathology. Volume 36:Number 1(2015)
• Publication Date: 2015-03
• Subjects: acute encephalopathy -- influenza -- cytokine storm -- infants -- clasmatodendrosis; Medical jurisprudence -- Periodicals; Forensic pathology -- Periodicals; 614.105
• DOI: 10.1097/PAF.0000000000000129
• Languages: English
• ISSNs: 0195-7910

Abstract

Abstract : Abstract: Cytokine storm–derived influenza–associated encephalopathy is a severe complication, affecting not only the brain but also multiple systemic organs including the heart and lungs. Hundreds of Japanese children are afflicted by influenza-associated encephalopathy every year. Influenza-associated encephalopathy can be diagnosed by pathological changes, such as advanced brain edema and disruption of astrocytic projections, which is known as clasmatodendrosis . In the present case, despite the absence of significant histopathological findings in the brain, the diagnosis of influenza-associated encephalopathy was made on the basis of autopsy findings such as brain swelling, pathological findings including diffuse alveolar damage, and increase in the concentrations of interleukin-6 in both the serum and cerebrospinal fluid. In this case, the interval from high fever to death was approximately 7 hours and may have been too short for histopathological features to develop. This is an unusual autopsy case of cytokine storm–derived influenza–associated encephalopathy without typical histopathological findings.