1.Acute encephalopathy with callosal, subcortical and thalamic lesions
uko Nakano ; Yukifumi Monden ; Masashi Mizuguchi ; Masako Nagashima ; Yasunori Koike ; Yuji Gunji ; Naoto Takahashi ; Hideo Sugie ; MarikoY. Momoi ; Takanori Yamagata
Neurology Asia 2015;20(1):85-89
Acute encephalopathy is classified into multiple syndromes, such as acute encephalopathy with biphasic
seizures and late reduced diffusion (AESD), clinically mild encephalitis/encephalopathy with a reversible
splenial lesion (MERS) and acute necrotizing encephalopathy (ANE), characterized radiologically
by lesions in the cerebral subcortical white matter, splenium of the corpus callosum and bilateral
thalami, respectively. We described a previously healthy 8-year-old boy who had febrile and biphasic
seizures, and encephalopathy. MRI showed abnormal signal intensity in the corpus callosum on day
2 and cerebral subcortical white matter and bilateral thalamic lesions on day 8. This is the first case
of acute encephalopathy in which callosal, subcortical and thalamic lesions co-existed. The clinical
course of this case was typical for AESD, atypical for MERS, and different from that of ANE.
Brain Diseases
2.Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis.
Hideki KUMAGAI ; Koji YOKOYAMA ; Tomoyuki IMAGAWA ; Shun INOUE ; Janyerkye TULYEU ; Mamoru TANAKA ; Takanori YAMAGATA
Pediatric Gastroenterology, Hepatology & Nutrition 2016;19(3):214-220
Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (×2) and via a nasoduodenal tube (×4) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.
Abdominal Pain
;
Child*
;
Colectomy
;
Colitis, Ulcerative*
;
Dysbiosis
;
Enema
;
Fecal Microbiota Transplantation*
;
Feces
;
Female
;
Fever
;
Gastrointestinal Microbiome
;
Healthy Volunteers
;
Humans
;
Inflammatory Bowel Diseases
;
Microbiota
;
Tissue Donors
;
Ulcer*