Jung Sook Yeom1, Young-Soo Kim1, Ji-Hyun Seo1, Ji Sook Park1, Eun Sil Park1, Jae-Young Lim1, Hyang-Ok Woo1, Hee-Shang Youn1, Dae Seob Choi1, Ju-Young Chung1, Tae-Hee Han1, Chan-Hoo Park2. 1. From the Department of Pediatrics (J.S.Y., J.-H.S., J.S.P., E.S.P., J.-Y.L., H.-O.W., H.-S.Y., C.-H.P.), Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science (J.S.Y., J.-H.S., J.S.P., E.S.P., J.-Y.L., H.-O.W., H.-S.Y., C.-H.P.), Jinju; Department of Neurology (Y.-S.K.), Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon; Department of Radiology (D.S.C.), Gyeongsang National University School of Medicine, Jinju; and the Departments of Pediatrics (J.-Y.C.) and Diagnostic Laboratory Medicine (T.-H.H.), Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea. 2. From the Department of Pediatrics (J.S.Y., J.-H.S., J.S.P., E.S.P., J.-Y.L., H.-O.W., H.-S.Y., C.-H.P.), Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science (J.S.Y., J.-H.S., J.S.P., E.S.P., J.-Y.L., H.-O.W., H.-S.Y., C.-H.P.), Jinju; Department of Neurology (Y.-S.K.), Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon; Department of Radiology (D.S.C.), Gyeongsang National University School of Medicine, Jinju; and the Departments of Pediatrics (J.-Y.C.) and Diagnostic Laboratory Medicine (T.-H.H.), Sanggyepaik Hospital, Inje University College of Medicine, Seoul, Korea. aroma@gnu.ac.kr.
Abstract
OBJECTIVE: To report a consecutive series of neonates with seizures or apnea and displaying white matter injuries with distinctive magnetic resonance diffusion-weighted imaging (DWI) pattern, and to discuss the high positive rate of rotavirus infection seen in these patients. METHODS: In a retrospective review of neonates who were admitted to a tertiary referral center with seizures or apnea, we found a distinctive pattern of white matter injury (symmetrical restricted diffusion in the periventricular white matter and white matter tracts including the corpus callosum) in 18 patients. We describe the clinical and laboratory features of these 18 neonates. Additional PCR analyses for rotaviruses and parechoviruses were performed on banked frozen samples of CSF of 4 patients and blood of 15 patients. RESULTS: All 18 patients were born at term and healthy until symptoms occurred 4-7 days after birth. No history of asphyxia was observed. Only 1 patient presented with fever, and no patient showed a rash. All patients except 1 (94.4%) were rotavirus-positive in stool samples. However, neither rotaviruses nor enteroviruses/parechoviruses were detected in the CSF and blood. Tissue loss was observed in 5 of 8 subjects on repeat MRI scans. CONCLUSIONS: Neonates with this distinctive DWI pattern had a high positive rate of rotavirus infection, without evidence of other pathogens, and were characterized as term newborns with neurologic symptoms arising approximately the fifth day after birth. Although the specificity of this pattern is unclear, rotavirus testing should be considered for neonates presenting with this DWI pattern.
OBJECTIVE: To report a consecutive series of neonates with seizures or apnea and displaying white matter injuries with distinctive magnetic resonance diffusion-weighted imaging (DWI) pattern, and to discuss the high positive rate of rotavirus infection seen in these patients. METHODS: In a retrospective review of neonates who were admitted to a tertiary referral center with seizures or apnea, we found a distinctive pattern of white matter injury (symmetrical restricted diffusion in the periventricular white matter and white matter tracts including the corpus callosum) in 18 patients. We describe the clinical and laboratory features of these 18 neonates. Additional PCR analyses for rotaviruses and parechoviruses were performed on banked frozen samples of CSF of 4 patients and blood of 15 patients. RESULTS: All 18 patients were born at term and healthy until symptoms occurred 4-7 days after birth. No history of asphyxia was observed. Only 1 patient presented with fever, and no patient showed a rash. All patients except 1 (94.4%) were rotavirus-positive in stool samples. However, neither rotaviruses nor enteroviruses/parechoviruses were detected in the CSF and blood. Tissue loss was observed in 5 of 8 subjects on repeat MRI scans. CONCLUSIONS: Neonates with this distinctive DWI pattern had a high positive rate of rotavirus infection, without evidence of other pathogens, and were characterized as term newborns with neurologic symptoms arising approximately the fifth day after birth. Although the specificity of this pattern is unclear, rotavirus testing should be considered for neonates presenting with this DWI pattern.
Authors: D G Corrêa; T A L Freddi; H Werner; F P P L Lopes; M E L Moreira; F C P de Almeida Di Maio Ferreira; J M de Andrade Lopes; F C Rueda-Lopes; L C H da Cruz Journal: AJNR Am J Neuroradiol Date: 2019-12-05 Impact factor: 3.825
Authors: H Kidokoro; L S de Vries; C Ogawa; Y Ito; A Ohno; F Groenendaal; S Saitoh; A Okumura; Y Ito; J Natsume Journal: J Perinatol Date: 2017-07-20 Impact factor: 2.521
Authors: Sung Eun Park; Dae Seob Choi; Hwa Seon Shin; Hye Jin Baek; Ho Cheol Choi; Ji Eun Kim; Hye Young Choi; Mi Jung Park Journal: Korean J Radiol Date: 2017-05-19 Impact factor: 3.500