Acute necrotizing encephalopathy associated with RANBP2 mutation: Value of MRI findings for diagnosis and intervention

dc.authorid0000-0003-1513-6149
dc.contributor.authorSarıgeçili, Esra
dc.contributor.authorKoç Uçar, Habibe
dc.contributor.authorHavalı, Cengiz
dc.contributor.authorCansu, Ali
dc.contributor.authorAydın, Kürşad
dc.date.accessioned2023-09-13T12:46:43Z
dc.date.available2023-09-13T12:46:43Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractIntroduction: Acute necrotizing encephalopathy (ANEC) is a rare entity characterized by encephalopathy following a febrile illness. Most patients are sporadic; however, recurrent and familial cases have been associated with RAN-binding protein 2 (RANBP2) mutation. Well-defined MRI findings can even be life-saving with early diagnosis and treatment. Methods: In this article, nine pediatric cases diagnosed with ANEC1 both clinically and radiologically, and with least one variation in the RANBP2 gene, are presented. Results: All patients were previously healthy and presented with encephalopathy after an acute febrile infection. The patients of 44% had a similar attack history in their family. Influenza A/B was detected in 7 patients (78%). One patient was admitted at age 32 years old. The first clinical findings of patients were encephalopathy (100%), seizure (44%), vision problems (33%), ataxia (11%), and monoplegia (11%). Recurrent attacks were seen in two (22%) patients. Brain MRI findings including bilateral thalamus, external capsules, and brainstem involvements were highly suggestive for RANBP2 mutation. Based on MRI findings, genetic analyses were quickly performed and confirmed. All of the patients were treated with empirical encephalitis treatment, oseltamivir, intravenous immunoglobulin (IVIG), high-dose steroid and, if necessary, plasmapheresis, but three (33%) patients died despite treatment. Conclusion: ANEC associated with RANBP2 mutation may occur early or late-onset and can be recurrent and fatal. Therefore, early diagnosis and treatment have the potential to modify the severity of this encephalopathy. Well-defined MRI findings are highly instructive for early diagnosis.
dc.identifier.citationSarıgeçili, E., Koç Uçar, H., Havalı, C., Cansu, A. ve Aydın, K. (2023). Acute necrotizing encephalopathy associated with RANBP2 mutation: Value of MRI findings for diagnosis and intervention. Acta Neurologica Belgica, 123(2), 571-582. https://dx.doi.org/10.1007/s13760-022-02166-x
dc.identifier.doi10.1007/s13760-022-02166-x
dc.identifier.endpage582
dc.identifier.issn0300-9009
dc.identifier.issn2240-2993
dc.identifier.issue2
dc.identifier.pmid36572756
dc.identifier.scopus2-s2.0-85144854923
dc.identifier.scopusqualityQ2
dc.identifier.startpage571
dc.identifier.urihttps://dx.doi.org/10.1007/s13760-022-02166-x
dc.identifier.urihttps://hdl.handle.net/20.500.12511/11425
dc.identifier.volume123
dc.identifier.wos000904014100001en_US
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorAydın, Kürşad
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofActa Neurologica Belgicaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectAcute Necrotizing Encephalopathy
dc.subjectANEC
dc.subjectMRI
dc.subjectRANBP2
dc.subjectTreatment
dc.titleAcute necrotizing encephalopathy associated with RANBP2 mutation: Value of MRI findings for diagnosis and intervention
dc.typeArticle

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