HPeV3-associated acute encephalitis/encephalopathy among Japanese infants
Related Experiment Video
Updated: Nov 22, 2025
Bacterial Artificial Chromosomes: A Functional Genomics Tool for the Study of Positive-strand RNA Viruses
Published on: December 29, 2015
Yuichi Abe1, Takuro Ohno2, Hiroshi Matsumoto3
1Department of Pediatrics, Saitama Medical University, Saitama, Japan; Division of Neurology, National Center for Child Health and Development, Tokyo, Japan.
Insights
Human parechovirus type 3 (HPeV3) encephalitis in infants shows similar clinical signs regardless of MRI findings. Early brain MRI is crucial for diagnosing HPeV3 encephalitis with brain lesions in severely ill infants.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Human parechovirus type 3 (HPeV3) can cause acute encephalitis/encephalopathy (HPeV3E/E) in infants.
- Distinguishing HPeV3E/E with abnormal brain MRI findings from those without is clinically important.
Purpose of the Study:
- To compare clinical characteristics of HPeV3E/E in infants with and without abnormal brain MRI findings.
- To identify potential differences that could aid in early diagnosis.
Main Methods:
- Retrospective study of 32 infants diagnosed with HPeV3E/E in Japan (2014-2016).
- Patients were categorized into MRI-positive (n=17) and MRI-negative (n=6) groups based on brain MRI findings.
- Clinical data, lab results, and symptoms were analyzed.
Main Results:
- No significant differences in clinical lab results or symptoms were observed between MRI-positive and MRI-negative groups, except for gastrointestinal symptoms in the MRI-negative group.
- MRI-positive infants showed white matter involvement and some developed lesions on follow-up MRI.
- Half of the infants with follow-up lesions (4/8) experienced neurological sequelae.
Conclusions:
- Clinical presentation of HPeV3E/E does not significantly differ between infants with and without brain MRI lesions.
- Frequent brain MRI is recommended for febrile infants with severe illness during HPeV3 outbreaks to detect potential brain lesions early.
Objective:
The current study aimed to identify and compare the clinical characteristics of human parechovirus type 3 (HPeV3)-associated acute encephalitis/encephalopathy (HPeV3E/E) between infants with abnormal brain magnetic resonance imaging (MRI) findings (typical, or MRI-positive HPeV3E/E) and those with MRI-negative findings (MRI-negative HPeV3E/E).
Methods:
This is a retrospective study on patients with HPeV3 infection, and a two-step questionnaire survey performed on 837 hospitals in Japan between 2014 and 2016.
Results:
We identified 240 infants with HPeV3 infection, of which 34 had been clinically-diagnosed HPeV3E/E (cHPeV3E/E). However, detailed clinical data were provided by 32 of the 34 patients. Among these 32, 23 had undergone MRI and were categorized into two groups, MRI-positive (n = 17) and -negative (n = 6). There were no significant intergroup differences in clinical lab results or symptoms, except for gastrointestinal symptoms that were only present in the MRI-negative patients. The MRI-positive group showed white matter involvement on brain MRI during the acute phase, and 8 patients presented with lesions on follow-up MRI. Furthermore, 4 (50%) of the 8 patients had neurological sequelae.
Conclusion:
Clinical characteristics of cHPeV3E/E patients with and without lesions on brain MRI showed no significant differences. Therefore, considering the difficulty in distinguishing febrile infants with cHPeV3E/E from those with a sepsis-like illness, during an HPeV3 infection epidemic, it is imperative to frequently perform brain MRI in febrile infants presenting with severe disease for the early diagnosis of HPeV3E/E presenting with brain lesions.
More Related Videos
09:37Detection of Polyfunctional T Cells in Children Vaccinated with Japanese Encephalitis Vaccine via the Flow Cytometry Technique
Published on: September 23, 2022
06:22Standardization of Transfer across Labs between Flow Cytometers for Detection of Lymphocytes in Japanese Encephalitis Vaccinated Children
Published on: February 10, 2023
