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Case report
Neuro-ophthalmological consequences of acute influenza A encephalitis in a genetically predisposed child
  1. Catarina Xavier1,
  2. Miguel Boncquet Vieira1,
  3. Cristina Ferreira1,2,3 and
  4. Joana Tavares Ferreira2,3,4
  1. 1Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  2. 2Ophthalmology, Hospital CUF de Cascais, Cascais, Portugal
  3. 3Ophthalmology, Hospital CUF Descobertas, Lisboa, Portugal
  4. 4Ophthalmology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
  1. Correspondence to Professor Joana Tavares Ferreira; joanaptf{at}gmail.com

Abstract

Acute necrotising encephalopathy (ANE) is a rare disease that corresponds to a rapidly progressive encephalopathy induced by a viral infection. It is frequently associated with a mutation on the RAN-binding protein 2 (RANBP2) gene–ANE1. We present a case of a 5-year-old boy with a clinical picture of influenza aggravated to an acute encephalopathy picture after the 3rd day. Complementary examinations came back positive for the influenza A virus, and MRI showed aspects compatible with ANE. He was treated accordingly with subsequent improvement of the clinical picture. During ambulatory follow-up, a mutation was detected on the RANBP2 gene and, at the ophthalmological level, bilateral peripheral constriction on the campimetry and a significant reduction of bilateral peripapillary retinal nerve fibre layer was reported. Our case contributes to the enrichment of the neuro-ophthalmological literature and expands the spectrum of sequelae of this rare entity in the Caucasian population.

  • visual pathway
  • infection (neurology)
  • neuroopthalmology
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Footnotes

  • Contributors CX, substantial contributions to the conception and design of the work, the acquisition, analysis and interpretation of data; drafting the work; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MBV, drafting the work and revising it critically for important intellectual content. CF, substantial contributions to the acquisition, analysis and interpretation of data. JTF, substantial contributions to the conception and design of the work, and the acquisition, analysis ans interpretation of data; revising the work critically for important intellectual content; final approval of the version published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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