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Acute disseminated encephalomyelitis and poststreptococcal acute glomerulonephritis

Shu-ichi Ito1, Atsuo Nezu, Chizuru Matsumoto

  • 1Department of Pediatrics, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, 232-0024 Japan. sk-ito@tb3.so-net.ne.jp

Brain & Development
|March 14, 2002
PubMed

Insights

A boy with acute disseminated encephalomyelitis and acute glomerulonephritis showed rapid improvement with methylprednisolone therapy. Streptococcus pyogenes infection was identified, suggesting a coincidental role in both neurological and kidney conditions.

Area of Science:

  • Neurology
  • Nephrology
  • Infectious Diseases

Background:

  • Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disease of the central nervous system.
  • Acute glomerulonephritis (AGN) is kidney inflammation often caused by infections, notably Streptococcus pyogenes.
  • Concurrent presentation of ADEM and AGN is exceptionally uncommon.

Observation:

  • A pediatric patient presented with symptoms of both ADEM and AGN.
  • Magnetic resonance imaging (MRI) revealed multiple brain lesions primarily in the cortical gray matter.
  • Renal biopsy confirmed poststreptococcal acute glomerulonephritis.

Findings:

  • The patient's neurological symptoms and brain lesions showed a rapid positive response to intravenous methylprednisolone pulse therapy.
  • Throat culture and serological tests confirmed Streptococcus pyogenes infection.
  • The clinical course suggested a coincidental occurrence of S. pyogenes infection triggering both ADEM and AGN.

Implications:

  • This case highlights the importance of considering infectious triggers for neurological and renal inflammatory conditions.
  • The prompt response to immunosuppressive therapy in ADEM suggests an autoimmune component.
  • Further research may elucidate the potential link between Streptococcus pyogenes infections and the development of ADEM alongside AGN.

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