Acute disseminated encephalomyelitis risk factors: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
===[[Infections]]=== | ===[[Infections]]=== | ||
* The [[pathogens]] remain mostly unknown. | * The [[pathogens]] remain mostly unknown<ref name="pmid11226729">{{cite journal| author=Hung KL, Liao HT, Tsai ML| title=The spectrum of postinfectious encephalomyelitis. | journal=Brain Dev | year= 2001 | volume= 23 | issue= 1 | pages= 42-5 | pmid=11226729 | doi=10.1016/s0387-7604(00)00197-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11226729 }}</ref>. | ||
* The [[prodromal ]] phase is characterised by [[flu]] | * The [[prodromal ]] phase is characterised by [[flu|flu-like]] [[symptoms]] (56-61%) and non-specific upper [[respiratory]] or [[gastrointestinal]] manifestations. The latent period varies from 4 to 41 days<ref name="pmid26620160">{{cite journal| author=Berzero G, Cortese A, Ravaglia S, Marchioni E| title=Diagnosis and therapy of acute disseminated encephalomyelitis and its variants. | journal=Expert Rev Neurother | year= 2016 | volume= 16 | issue= 1 | pages= 83-101 | pmid=26620160 | doi=10.1586/14737175.2015.1126510 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26620160 }}</ref>. | ||
*[[Viral]] [[exanthems]] usually precede the onset of [[pediatric]] [[ADEM]]. | *[[Viral]] [[exanthems]] usually precede the onset of [[pediatric]] [[ADEM]]<ref name="pmid266201603">{{cite journal| author=Berzero G, Cortese A, Ravaglia S, Marchioni E| title=Diagnosis and therapy of acute disseminated encephalomyelitis and its variants. | journal=Expert Rev Neurother | year= 2016 | volume= 16 | issue= 1 | pages= 83-101 | pmid=26620160 | doi=10.1586/14737175.2015.1126510 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26620160 }}</ref>. | ||
* The most common associated [[pathogens]] are viruses namely, [[Epstein-Barr]], [[measles]], [[mumps]], [[rubella]] | * The most common associated [[pathogens]] are viruses namely, [[Epstein-Barr]], [[measles]], [[mumps]], [[rubella]] and [[coxsackie B]]<ref name="pmid266201604">{{cite journal| author=Berzero G, Cortese A, Ravaglia S, Marchioni E| title=Diagnosis and therapy of acute disseminated encephalomyelitis and its variants. | journal=Expert Rev Neurother | year= 2016 | volume= 16 | issue= 1 | pages= 83-101 | pmid=26620160 | doi=10.1586/14737175.2015.1126510 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26620160 }}</ref>. [[Bacteria]] like [[Borrelia]] [[burgdorferi]], [[Legionella]] and [[Mycoplasma]] are infrequently reported<ref name="pmid16286539">{{cite journal| author=Menge T, Hemmer B, Nessler S, Wiendl H, Neuhaus O, Hartung HP | display-authors=etal| title=Acute disseminated encephalomyelitis: an update. | journal=Arch Neurol | year= 2005 | volume= 62 | issue= 11 | pages= 1673-80 | pmid=16286539 | doi=10.1001/archneur.62.11.1673 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16286539 }}</ref><ref name="pmid26079482">{{cite journal| author=Esposito S, Di Pietro GM, Madini B, Mastrolia MV, Rigante D| title=A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 10 | pages= 923-9 | pmid=26079482 | doi=10.1016/j.autrev.2015.06.002 | pmc=7105213 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26079482 }}</ref>. | ||
* [[ADEM]] shows a seasonal variation with increased [[incidence]] in winter and spring, probably due to the changes in the distribution of the implicated agents. | * [[ADEM]] shows a seasonal variation with increased [[incidence]] in winter and spring, probably due to the changes in the distribution of the implicated agents. | ||
===[[Vaccinations]]=== | ===[[Vaccinations]]=== | ||
*[[Immunization]] is the precipitating factor for less than 5% of [[ADEM]] cases. | *[[Immunization|Immunisation]] is the precipitating factor for less than 5% of [[ADEM]] cases<ref name="pmid260794822">{{cite journal| author=Esposito S, Di Pietro GM, Madini B, Mastrolia MV, Rigante D| title=A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children. | journal=Autoimmun Rev | year= 2015 | volume= 14 | issue= 10 | pages= 923-9 | pmid=26079482 | doi=10.1016/j.autrev.2015.06.002 | pmc=7105213 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26079482 }}</ref>. | ||
* The most frequent occurrences are with | * The most frequent occurrences are with [[measles]], [[mumps]] and [[rubella]] [[vaccines]]. | ||
* The latent period varies from 2 to 30 days. | * The latent period varies from 2 to 30 days. | ||
===[[Genetic]] susceptibility=== | ===[[Genetic]] susceptibility=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
Risk Factors
Infections
- The pathogens remain mostly unknown[1].
- The prodromal phase is characterised by flu-like symptoms (56-61%) and non-specific upper respiratory or gastrointestinal manifestations. The latent period varies from 4 to 41 days[2].
- Viral exanthems usually precede the onset of pediatric ADEM[3].
- The most common associated pathogens are viruses namely, Epstein-Barr, measles, mumps, rubella and coxsackie B[4]. Bacteria like Borrelia burgdorferi, Legionella and Mycoplasma are infrequently reported[5][6].
- ADEM shows a seasonal variation with increased incidence in winter and spring, probably due to the changes in the distribution of the implicated agents.
Vaccinations
- Immunisation is the precipitating factor for less than 5% of ADEM cases[7].
- The most frequent occurrences are with measles, mumps and rubella vaccines.
- The latent period varies from 2 to 30 days.
Genetic susceptibility
- An association between ADEM and HLA-DR genes has been elucidated in a recent study.
- Patients with congenital adrenal hyperplasia or acquired adrenal insufficiency have been reported to suffer from a sequelae of encephalopathy with white matter lesions.
References
- ↑ Hung KL, Liao HT, Tsai ML (2001). "The spectrum of postinfectious encephalomyelitis". Brain Dev. 23 (1): 42–5. doi:10.1016/s0387-7604(00)00197-2. PMID 11226729.
- ↑ Berzero G, Cortese A, Ravaglia S, Marchioni E (2016). "Diagnosis and therapy of acute disseminated encephalomyelitis and its variants". Expert Rev Neurother. 16 (1): 83–101. doi:10.1586/14737175.2015.1126510. PMID 26620160.
- ↑ Berzero G, Cortese A, Ravaglia S, Marchioni E (2016). "Diagnosis and therapy of acute disseminated encephalomyelitis and its variants". Expert Rev Neurother. 16 (1): 83–101. doi:10.1586/14737175.2015.1126510. PMID 26620160.
- ↑ Berzero G, Cortese A, Ravaglia S, Marchioni E (2016). "Diagnosis and therapy of acute disseminated encephalomyelitis and its variants". Expert Rev Neurother. 16 (1): 83–101. doi:10.1586/14737175.2015.1126510. PMID 26620160.
- ↑ Menge T, Hemmer B, Nessler S, Wiendl H, Neuhaus O, Hartung HP; et al. (2005). "Acute disseminated encephalomyelitis: an update". Arch Neurol. 62 (11): 1673–80. doi:10.1001/archneur.62.11.1673. PMID 16286539.
- ↑ Esposito S, Di Pietro GM, Madini B, Mastrolia MV, Rigante D (2015). "A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children". Autoimmun Rev. 14 (10): 923–9. doi:10.1016/j.autrev.2015.06.002. PMC 7105213 Check
|pmc=value (help). PMID 26079482. - ↑ Esposito S, Di Pietro GM, Madini B, Mastrolia MV, Rigante D (2015). "A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children". Autoimmun Rev. 14 (10): 923–9. doi:10.1016/j.autrev.2015.06.002. PMC 7105213 Check
|pmc=value (help). PMID 26079482.