Akut Dissemine Ensefalomiyelit (ADEM)
Özet
Akut dissemine ensefalomiyelit (ADEM), genellikle çocukluk çağında viral enfeksiyonları takiben ortaya çıkan, merkezi sinir sistemini etkileyen immün aracılı bir demiyelinizan hastalıktır. Ensefalopati ve multifokal nörolojik bulgularla karakterize olan bu tablo, tipik MRG lezyonları ve klinik kriterler ile teşhis edilir. Tedavide temel yaklaşım yüksek doz kortikosteroidler olmakla birlikte, intravenöz immünoglobulin ve plazmaferez gibi yöntemler de tercih edilebilir. Çoğu vakada iyileşme beklense de, nadiren görülen multifazik seyir ve diğer demiyelinizan hastalıklarla ayırıcı tanı büyük önem taşır.
Acute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating condition of the central nervous system that typically occurs in children following viral infections. Characterized by encephalopathy and multifocal neurological symptoms, diagnosis is established through specific clinical and MRI criteria to distinguish it from other conditions like multiple sclerosis. High-dose corticosteroids serve as the primary treatment, with intravenous immunoglobulin or plasma exchange utilized as secondary options. While most pediatric patients recover well, careful monitoring is essential due to the possibility of multifocal courses and the need to differentiate from chronic demyelinating disorders.
Referanslar
Cole J, Evans E, Mwangi M, Mar S. Acute disseminated encephalomyelitis in children: an updated review based on current diagnostic criteria. Pediatric neurology 2019; 100: 26-34.
Lotze TE, Chadwick DJ. Acute disseminated encephalomyelitis (ADEM) in children: Pathogenesis, clinical features, and diagnosis. 2021.
Massa S, Fracchiolla A, Neglia C, Argentiero A, Esposito S. Update on Acute Disseminated Encephalomyelitis in Children and Adolescents. Children 2021; 8(4): 280.
Johnston M, Ouvrier R. Aicardi’s Diseases of the Nervous System in Childhood 4th Edition. 4th ed; 2018.
Krupp LB, Banwell B, Tenembaum S. Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology 2007; 68(16 suppl 2): S7-S12.
Krupp LB, Tardieu M, Amato MP, et al. International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Multiple Sclerosis Journal 2013; 19(10): 1261-7.
Alper G. Acute disseminated encephalomyelitis. Journal of child neurology 2012; 27(11): 1408-25.
Xiong C-h, Yan Y, Liao Z, et al. Epidemiological characteristics of acute disseminated encephalomyelitis in Nanchang, China: a retrospective study. BMC Public Health 2014; 14(1): 1-6.
Ketelslegers I, Visser I, Neuteboom R, Boon M, Catsman-Berrevoets C, Hintzen R. Disease course and outcome of acute disseminated encephalomyelitis is more severe in adults than in children. Multiple Sclerosis Journal 2011; 17(4): 441-8.
Torisu H, Kira R, Ishizaki Y, et al. Clinical study of childhood acute disseminated encephalomyelitis, multiple sclerosis, and acute transverse myelitis in Fukuoka Prefecture, Japan. Brain and Development 2010; 32(6): 454-62.
Leake JAD, Albani S, Kao AS, et al. Acute Disseminated Encephalomyelitis in Childhood: Epidemiologic, Clinical and Laboratory Features. The Pediatric Infectious Disease Journal 2004; 23(8): 756-64.
Boesen MS, Magyari M, Koch-Henriksen N, et al. Implications of the International Paediatric Multiple Sclerosis Study Group Consensus Criteria for Paediatric Acute Disseminated Encephalomyelitis: a Nationwide Validation Study (S35. 005). AAN Enterprises; 2018.
Banwell B, Kennedy J, Sadovnick D, et al. Incidence of acquired demyelination of the CNS in Canadian children. Neurology 2009; 72(3): 232-9.
Mikaeloff Y, Adamsbaum C, Husson B, et al. MRI prognostic factors for relapse after acute CNS inflammatory demyelination in childhood. Brain 2004; 127(9): 1942-7.
Absoud M, Lim MJ, Chong WK, et al. Paediatric acquired demyelinating syndromes: incidence, clinical and magnetic resonance imaging features. Multiple Sclerosis Journal 2013; 19(1): 76-86.
Pellegrino P, Radice S, Clementi E. Geoepidemiology of acute disseminated encephalomyelitis. Epidemiology 2014; 25(6): 928-9.
Fenichel GM. Neurological complications of immunization. Annals of neurology 1982; 12(2): 119-28.
Baxter R, Lewis E, Goddard K, et al. Acute demyelinating events following vaccines: a case-centered analysis. Clinical Infectious Diseases 2016; 63(11): 1456-62.
Pohl D, Alper G, Van Haren K, et al. Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology 2016; 87(9 Supplement 2): S38-S45.
Torisu H, Okada K. Vaccination-associated acute disseminated encephalomyelitis. Vaccine 2019; 37(8): 1126-9.
Parsons T, Banks S, Bae C, Gelber J, Alahmadi H, Tichauer M. COVID-19-associated acute disseminated encephalomyelitis (ADEM). Journal of neurology 2020; 267: 2799-802.
McCuddy M, Kelkar P, Zhao Y, Wicklund D. Acute Demyelinating Encephalomyelitis (ADEM) in COVID-19 Infection: A Case Series. MedRxiv 2020.
Koralnik IJ, Tyler KL. COVID‐19: a global threat to the nervous system. Annals of neurology 2020; 88(1): 1-11.
Javed A, Khan O. Acute disseminated encephalomyelitis. Handbook of clinical neurology 2014; 123: 705-17.
Yae Y, Kawano G, Yokochi T, et al. Fulminant acute disseminated encephalomyelitis in children. Brain and Development 2019; 41(4): 373-7.
Paolilo RB, Deiva K, Neuteboom R, Rostásy K, Lim M. Acute disseminated encephalomyelitis: current perspectives. Children 2020; 7(11): 210.
Kothur K, Wienholt L, Mohammad SS, et al. Utility of CSF cytokine/chemokines as markers of active intrathecal inflammation: comparison of demyelinating, anti-NMDAR and enteroviral encephalitis. PloS one 2016; 11(8): e0161656.
Wender M. Acute disseminated encephalomyelitis (ADEM). Journal of neuroimmunology 2011; 231(1-2): 92-9.
Wegner C. Pathological differences in acute inflammatory demyelinating diseases of the central nervous system. International MS journal 2005; 12(1): 13-9, 2.
Franciotta D, Zardini E, Ravaglia S, et al. Cytokines and chemokines in cerebrospinal fluid and serum of adult patients with acute disseminated encephalomyelitis. Journal of the neurological sciences 2006; 247(2): 202-7.
Miller SD, McRae BL, Vanderlugt CL, et al. Evolution of the T-cell repertoire during the course of experimental immune-mediated demyelinating diseases. Immunological reviews 1995; 144: 225-44.
Alves-Leon SV, Veluttini-Pimentel ML, Gouveia ME, et al. Acute disseminated encephalomyelitis: clinical features, HLA DRB1* 1501, HLA DRB1* 1503, HLA DQA1* 0102, HLA DQB1* 0602, and HLA DPA1* 0301 allelic association study. Arquivos de Neuro-psiquiatria 2009; 67: 643-51.
Tardieu M, Banwell B, Wolinsky JS, Pohl D, Krupp LB. Consensus definitions for pediatric MS and other demyelinating disorders in childhood. Neurology 2016; 87(9 Supplement 2): S8-S11.
Dundar NO, Anlar B, Guven A, Serdaroglu A, Yarar C. Relapsing acute disseminated encephalomyelitis in children: Further evaluation of the diagnosis. Journal of child neurology 2010; 25(12): 1491-7.
Pohl D, Rostasy K, Reiber H, Hanefeld F. CSF characteristics in early-onset multiple sclerosis. Neurology 2004; 63(10): 1966-7.
Santoro JD, Chitnis T. Diagnostic considerations in acute disseminated encephalomyelitis and the interface with MOG antibody. Neuropediatrics 2019; 50(05): 273-9.
Wynford-Thomas R, Jacob A, Tomassini V. Neurological update: MOG antibody disease. Journal of neurology 2019; 266(5): 1280-6.
Neuteboom R, Wilbur C, Van Pelt D, Rodriguez M, Yeh A. The spectrum of inflammatory acquired demyelinating syndromes in children. Seminars in pediatric neurology; 2017: Elsevier; 2017. p. 189-200.
Tenembaum SN. Acute disseminated encephalomyelitis. Handbook of clinical neurology 2013; 112: 1253-62.
Jarius S, Paul F, Aktas O, et al. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. Journal of neuroinflammation 2018; 15(1): 1-10.
López-Chiriboga AS, Majed M, Fryer J, et al. Association of MOG-IgG serostatus with relapse after acute disseminated encephalomyelitis and proposed diagnostic criteria for MOG-IgG–associated disorders. JAMA neurology 2018; 75(11): 1355-63.
Hennes E-M, Baumann M, Schanda K, et al. Prognostic relevance of MOG antibodies in children with an acquired demyelinating syndrome. Neurology 2017; 89(9): 900-8.
Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology 2002; 59(8): 1224-31.
Zuccoli G, Panigrahy A, Sreedher G, et al. Vasogenic edema characterizes pediatric acute disseminated encephalomyelitis. Neuroradiology 2014; 56(8): 679-84.
Chhabda S, Malik P, Reddy N, et al. Relapsing Demyelinating Syndromes in Children: A Practical Review of Neuroradiological Mimics. Frontiers in Neurology 2020; 11: 627.
Baumann M, Bartels F, Finke C, et al. EU paediatric MOG consortium consensus: Part 2–Neuroimaging features of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders. European Journal of Paediatric Neurology 2020.
Tenembaum S, Chitnis T, Ness J, Hahn JS. Acute disseminated encephalomyelitis. Neurology 2007; 68(16 suppl 2): S23-S36.
Rust RS. Multiple sclerosis, acute disseminated encephalomyelitis, and related conditions. Seminars in pediatric neurology; 2000: Elsevier; 2000. p. 66-90.
Wang CX. Assessment and Management of Acute Disseminated Encephalomyelitis (ADEM) in the Pediatric Patient. Pediatric Drugs 2021; 23(3): 213-21.
Anlar B, Basaran C, Kose G, et al. Acute disseminated encephalomyelitis in children: outcome and prognosis. Neuropediatrics 2003; 34(04): 194-9.
Lotze TE, Chadwick DJ. Acute disseminated encephalomyelitis (ADEM) in children: Treatment and prognosis.
Minagar A, Alezander JS. Inflammatory disorders of the nervous system: pathogenesis, immunology, and clinical management: Springer; 2005.
Suppiej A, Cainelli E, Casara G, Cappellari A, Nosadini M, Sartori S. Long-term neurocognitive outcome and quality of life in pediatric acute disseminated encephalomyelitis. Pediatric Neurology 2014; 50(4): 363-7.
