You are here

Article Text

Article menu
Download PDFPDF
Case Reports: Rare disease
Paediatric acute haemorrhagic leukoencephalitis
  1. Harshita Bamnawat1,
  2. Daisy Khera1,
  3. Siyaram Didel1 and
  4. Sarbesh Tiwari2
  1. 1Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  2. 2Radiodiagnosis, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  1. Correspondence to Dr Daisy Khera; pushpinderdaisy{at}gmail.com

Abstract

We report a case of a preschool age girl, previously healthy, referred to our hospital on ventilatory support with a history of vomiting, headache, and rapid neurological worsening within 24 hours in the form of seizures, encephalopathy and loss of consciousness. On presentation, she was deeply comatose with dilated non-reactive pupils, absent brainstem reflexes and flaccid quadriplegia. Diagnosis of acute haemorrhagic leukoencephalitis was considered based on laboratory and neuroimaging findings. MRI of the brain showed fluffy white matter hyperintensities and microhaemorrhages in bilateral cerebral hemispheres and thalami. Aggressive treatment with methylprednisolone, plasmapheresis and intravenous immunoglobulin showed dramatic improvement with no neurological sequelae. Our case is unique in a way that despite the hyperacute onset and rapid deterioration, with a fulminant course in the intensive care unit, the child recovered dramatically with aggressive management.

  • Paediatrics (drugs and medicines)
  • Neurology (drugs and medicines)
  • Paediatric intensive care

https://doi.org/10.1136/bcr-2021-246654

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors HB made substantial contributions to the conception and drafting of the work and revising it critically for important intellectual content and finally approved the version to be published and agreed 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. DK made substantial contributions to the conception and drafting of the work and revising it critically for important intellectual content and finally approved the version to be published and agreed 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. SD made substantial contributions to the drafting of the work and revising it critically for important intellectual content and finally approved the version to be published and agreed 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. ST made substantial contributions to the drafting of the work and revising it critically for important intellectual content and finally approved the version to be published and agreed 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.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

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