Cardiac troponin I: A reliable marker and early myocardial involvement with meningoencephalitis after fatal enterovirus-71 infection

Yung Feng Huang, P. C. Chiu, C. C. Chen, Y. Y. Chen, K. S. Hsieh, Y. C. Liu, P. H. Lai, H. W. Chang

研究成果: 雜誌貢獻文章同行評審

25 引文 斯高帕斯(Scopus)

摘要

Objectives: A major outbreak of enterovirus 71 (EV71) in Taiwan in 1998 caused many severe cases and 78 deaths. Our purpose was to find reliable markers and early indicators of fatal EV71 central nervous system (CNS) infection. Methods: From June 2000 to November 2001, 21 patients with hand foot mouth disease or herpangina with CNS infection were admitted to Kaohsiung Veterans General Hospital. All 21 had culture-confirmed EV71 infection or were EV71 IgM positive. Patients were divided into two groups: group I included the five fatalities at our institution and group II, the 16 surviving patients. Results: Of the 21 infants and children with EV71 infection with CNS involvement, MR imaging studies were completed on 17, and 15 showed hyperintensity in the posterior portions of brain stem. All patients received intravenous immunoglobulin (IVIG) 1 g/day for two days and supportive care. Five patients rapidly deteriorated owing to irreversible hypotension and died. The other 16 patients recovered completely without sequel. In group I patients, the decrease of cardiac ejection function is significant and laboratory findings showed lower platelet count (P=0.0192). The mean of initial cTnI level for groups I and II was 10.6±11.6 and 0.48±0.55 ng/dl, respectively, higher in group I than in II (P=0.0019). Conclusion: We hypothesized that like patients with severe burns, those with severe EV-71 CNS meningoencephalitis have varying degrees of non-ischemic cardiac injury, manifesting as leakage of cTnI from myocytes into the circulation. EV-71 CNS meningoencephalitis likely to die with an early myocardial involvement evidenced by reduced ejection fraction and release of cTnI. We conclude that fatal EV71 CNS infection quickly leads to death due to severe encephalopathy associated with cardiomyopathy.

原文英語
頁(從 - 到)238-243
頁數6
期刊Journal of Infection
46
發行號4
DOIs
出版狀態已發佈 - 五月 2003
對外發佈

ASJC Scopus subject areas

  • 應用微生物與生物技術
  • 微生物學
  • 寄生物學
  • 病毒學
  • 免疫學和過敏
  • 傳染性疾病

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