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[Encephalomyocarditis syndrome]
1Landesfachkrankenhaus für Psychiatrie und Neurologie Mühlhausen.
Abstract:
From 28 autopsy-cases with EMC, among them 10 with an age from 7 days to 16 years, had been none diagnosed clinically before. Typically we found an interstitial myocarditis and perivenous encephalitis with a preferred participation of the brain stem. Central failure was dominating cause of death. There were only 5 cases (3 adults) with meningitis. Myelitis was not found. Former cardiac, less often cerebral lesions are likely risks for the lethal event.
Insights
Enteroviral myocarditis (EMC) is often undiagnosed before death, with autopsy revealing interstitial myocarditis and encephalitis. Central nervous system failure was the primary cause of death in these cases.
Area of Science:
- Neuropathology
- Cardiovascular Pathology
- Pediatric Pathology
Context:
- Autopsy studies provide crucial insights into diseases not diagnosed during life.
- Enteroviral infections can lead to severe cardiac and neurological complications.
- Pediatric cases of enteroviral myocarditis (EMC) often present diagnostic challenges.
Purpose:
- To investigate the clinicopathological findings of enteroviral myocarditis (EMC) in autopsy cases.
- To identify the typical pathological features and causes of death in EMC.
- To assess the frequency of associated neurological involvement, such as encephalitis and meningitis.
Summary:
- Autopsy of 28 EMC cases, including 10 pediatric cases (7 days to 16 years), revealed undiagnosed interstitial myocarditis and perivenous encephalitis, predominantly affecting the brain stem.
- Central nervous system failure was the main cause of death.
- Meningitis was observed in only 5 cases; myelitis was absent.
- Pre-existing cardiac or cerebral lesions were identified as potential risk factors for fatal outcomes.
Impact:
- Highlights the underdiagnosis of EMC, emphasizing the need for improved clinical recognition.
- Underscores the significant role of neuropathology in understanding EMC pathogenesis.
- Provides critical data for clinicians managing pediatric and adult patients with suspected enteroviral infections.