Biomedical subjects
Publications and source records attributed to Atsushi Kamei.
A 3-year-old boy with Kawasaki disease developed a cerebral infarction after high-dose intravenous immunoglobulin. Aspirin did not prevent the stroke. Based on the numerous reports of thrombosis due to high-dose immunoglobulin in older individuals, we conclude that it is necessary to be aware of this complication when treating children with Kawasaki disease.
We report a 16-month-old boy with human herpes virus-6 (HHV-6) encephalopathy showing transient abnormalities of the cerebral white matter on magnetic resonance imaging. Diffusion-weighted imaging (DWI) demonstrated diffuse high signal intensity in the bilateral cerebral white matter areas. The signal changes on DWI subsequently resolved, and cerebral atrophy resulted. The transient decrease in the cerebral white matter diffusivity seen in the present case may reflect axonal involvement secondary to the glial or neuronal damage in HHV-6 encephalopathy.
Three Japanese patients with peroxisomal acyl coenzyme A oxidase deficiency who manifested psychomotor retardation and regression during the late infantile period showed characteristic patterns of demyelination in the ponto- medullary corticospinal tracts and in the cerebellar and cerebral white matter. Molecular investigations revealed 2 novel missense mutations, M278V and G178C.
Characteristic pathologic changes of cranial computed tomography (CT) and magnetic resonance imaging (MRI) have never been reported in "Alice in Wonderland" syndrome (AIWS) caused by Epstein-Barr (EB) virus infection. We present here a 10-year-old girl with AIWS with an abnormal MR finding. During the course of serologically confirmed EB virus encephalopathy, she had distortion of the body image, visual hallucinations and depersonalization characteristic of AIWS. MRI demonstrated transient T2 prolongation and swelling of the cerebral cortex, especially at the bilateral temporal lobes, bilateral cingulate gyrus, right upper frontal gyrus, bilateral caudate nucleus, and bilateral putamen, whereas CT showed no abnormalities. Transient MRI lesions were occasionally reported in patients with EB virus encephalopathy/encephalitis who presented visual illusions and psychotic reactions, although the diagnosis of AIWS was not described. We consider that any patient with symptoms of AIWS should have MRI because the abnormal MRI findings may disappear in a short period.