摘要
目的探讨伴甲状腺功能异常的儿童急性播散性脑脊髓炎(ADEM)的临床特征和诊断思路。方法回顾分析3例伴甲状腺功能异常的ADEM患儿的临床资料,并复习相关文献。结果2例男童(分别为3岁10个月、12岁),1例女童(8岁)。发病前均有发热,2例伴睡眠增多,1例伴烦躁,1例面神经异常。3例患儿的甲状腺过氧化物酶均升高,且与症状严重程度相关;2例患儿恢复期下降,1例无明显改变。3例患儿脑电图均有背景活动减慢;3例头颅MRI均异常,其中2例颈MRI也异常。结论ADEM合并甲状腺功能异常少见,需与桥本脑病相鉴别。
Objective To explore the clinical features and diagnosis of acute disseminated encephalomyelitis (ADEM) in children with thyroid dysfunction. Methods The clinical data of ADEM with thyroid dysfunction in 3 children were retrospectively analyzed, and the related literature was reviewed. Results There were two boys (3 years and 10 months old, 12 years old) and one girl (8 years old). All the children had fever prior to theonset, 2 patients hadincreased sleep, 1 patient hadirritability, and 1 patient hadfacial nerve abnormality. Thyroperoxidase was elevated in all 3 children and correlated with the severity of symptoms. During the recovery period, thyroperoxidase was decreased in 2 children and not significantly changed in 1 child. Electroencephalogram showed that the background activity was decreased in 3 cases. Brain magnetic resonance imaging (MRI) showed abnormal in 3 cases, and neck MRI showed abnormal in 2 cases. Conclusions ADEM with thyroid dysfunction is rare and should be differentiated from Hashimoto encephalopathy.
作者
王媛媛
郑华城
崔晓普
郭四仙
王欣
杨花芳
WANG Yuanyuan;ZHENG Huacheng;CUI Xiaopu;GUO Sixian;WANG Xin;YANG Huafang(Department of Neurology,The Children’s Hospital of Hebei Province,Shijiazhuang 050030,Hebei,China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2019年第10期744-748,共5页
Journal of Clinical Pediatrics
基金
河北省医学科学研究重点课题计划(No.20180632)
关键词
急性播散性脑脊髓炎
甲状腺功能异常
桥本脑病
儿童
acute disseminated encephalomyelitis
thyroid dysfunction
Hashimoto's encephalopathy
child
