The Italian Journal of Neurological Sciences

, Volume 4, Issue 3, pp 329–334 | Cite as

Influenza B-associated Reye syndrome: report of a case with isolation of a coxsackie A5 virus from CSF

  • D'Angelo A. 
  • Ferrante P. 
  • Barbi Guidotti M. 
  • Provera F. 
Case Reports
  • 28 Downloads

Abstract

A 16 month old girl developed Reye syndrome a few days after an episode of influenza. The diagnosis of RS was made on clinical and laboratory data. Virological examinations were done on specimens of stools, throat swab, spinal fluid and two samples of serum. A coxsackievirus A5 was isolated from the spinal fluid. A seroconversion was found against the variant of influenza type B virus circulating in our region at that time and the isolated coxsackie A5 strain. The involvement in the CNS of coxsackie A5 and the demonstration of a simultaneous infection with influenza B virus supports the hypothesis that a mixed viral infection could trigger the Reye syndrome.

Key-words

Reye syndrome influenza B virus Coxsackievirus A5 mixed infection 

Sommario

Abbiamo studiato da un punto di vista clinico e virologico un caso di sindrome di Reye verificatosi in una bambina di 16 mesi pochi giorni dopo un episodio di influenza. La diagnosi di sindrome di Reye è stata posta sulla base di dati clinici e di laboratorio.

Le indagini virologiche sono state condotte su campioni di feci, tampone faringeo, liquor e su una coppia di sieri. Dal liquor è stato isolato un virus coxsackie A5. Nella coppia di sieri è stata stata evidenziata una sieroconversione verso la variante del virus influenzale di tipo B in circolazione nella regione a quell'epoca e verso il ceppo di virus coxsackie A5 isolato.

L'isolamento dal SNC del virus coxsackie A5 e la dimostrazione di una concomitante infezione da virus influenzale B nel caso da noi studiato depongono a favore dell'ipotesi che una infezione virale mista possa scatenare la sindrome di Reye.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    Reye R.D.K., Morgan G., andBaral J.:Encephalopathy and fatty degeneration of the viscera. A disease entity in childhood. Lancet, 2, 749–752, 1963.PubMedGoogle Scholar
  2. [2]
    Corey L., Rubin R.J., Hattwick M.A.W., Noble G.R. andCassidy E.:A Nationwide Outbreak of Reye's Syndrome. Am. J. Med. 61, 615–625, 1976.PubMedGoogle Scholar
  3. [3]
    Linnemann C.C., Shea L., Partin J.C., Schubert W.K. andSchiff G.M.:Reye's Syndrome: epidemiologic and viral studies. 1963–1974. Am. J. Epidemiol., 101, 517–526, 1975.PubMedGoogle Scholar
  4. [4]
    Huttenlocher P.R.:Reye's syndrome: Relation of outcome to therapy. J. Pediatr., 80, 845–850, 1972.PubMedGoogle Scholar
  5. [5]
    Lennette E.H., Schmidt N.J.:Diagnostic procedures for viral, rickettsial and chlamydial infections, 5th ed. Washington DC - American Public Health Association, 1979.Google Scholar
  6. [6]
    Meguro H., Bryant J.D., Torrence A.B. andWright P.F.:Canine kidney cell line for isolation of respiratory viruses, J. Clin. Micr., 2, 175, 1979.Google Scholar
  7. [7]
    Profeta M.L., Ballerini P.:La prova di inibizione dell'emoagglutinazione per i virus influenzali con antigeni trattati con tween-etere, Ann. Sclavo, 23, 530–542, 1981.PubMedGoogle Scholar
  8. [8]
    Bellmann M.H., Ross E.M., Miller D.L.:Reye's syndrome in children under three years old. Arch. Dis. Childh., 57, 259–263, 1982.PubMedCrossRefGoogle Scholar
  9. [9]
    Corey L., Rubin R.J., Bregman D., Gregg M.B.:Diagnostic criteria for influenza B-Associated Reye's syndrome: Clinical vs. Pathologic Criteria. Pediatrics, 65, 702–707, 1977.Google Scholar
  10. [10]
    Roe C.R., Schonberger L.B., Gelbach S.H., Wies L.A., Sidbury B.:Enzymatic alterations in Reye's syndrome: Prognostic implications, Pediatrics, 55, 119–126, 1975.PubMedGoogle Scholar
  11. [11]
    Pegelow C., Goldherg R., Turkel S. andPowars D.:Severe coagulation abnormalities in Reye syndrome J. Pediat. 91, 413–416, 1977.PubMedGoogle Scholar
  12. [12]
    Editorial:Reye's Syndrome. J. Infect. Dis. 125, 77–81, 1972.Google Scholar
  13. [13]
    Nelson D.B., Hurwitz E.S., Sullivan-Bolyai J.Z., Morens D.M., Schonberger L.B.:Reye's syndrome in the United States in 1977–1978, a non Influenza B virus year J. Infect. Dis. 140, 436–439, 1979.PubMedGoogle Scholar
  14. [14]
    Corey L., Rubin R.J., Thompson T.R., Noble G.R., Cassidy E., Hattwick M.A.W., Gregg M.B. andEddins D.:Influenza B associated Reye's syndrome: incidence in Michigan and potential for prevention. J. Infect. Dis., 135, 398–407, 1977.PubMedGoogle Scholar
  15. [15]
    Center for Diseases Control:Reye Syndrome-United States MMWR, 26, 67–68, 1977.Google Scholar
  16. [16]
    Editorial:Reye's Syndrome. Br. Med. J;, 3, 662–663, 1975.Google Scholar
  17. [17]
    Center for Diseases Control:Reye Syndrome-Ohio-Michigan, MMWR, 29, 532–539, 1980.Google Scholar
  18. [18]
    Aoki Y., Lombroso C.T.:Prognostic value of electroencephalography in Reye's syndrome. Neurology, 23, 333–343, 1973.PubMedGoogle Scholar

Copyright information

© Masson Italia Editori S.p.A. 1983

Authors and Affiliations

  • D'Angelo A. 
    • 1
  • Ferrante P. 
    • 2
  • Barbi Guidotti M. 
    • 2
  • Provera F. 
    • 3
  1. 1.Istituto Neurologico C. BestaMilano
  2. 2.Istituto di VirologiaUniversità di MilanoItalia
  3. 3.Divisione PediatricaOspedale di SondrioItalia

Personalised recommendations