カリフォルニア州における未知の原因の急性軟骨性髄炎 (2012年−2015年)
Keith Van Haren1, Patrick Ayscue2, Emmanuelle Waubant3
1Department of Neurology, Stanford University School of Medicine, Stanford, California2Division of Child Neurology, Lucile Packard Children's Hospital, Stanford, California.
JAMA
|January 1, 2016
まとめ
カリフォルニアの急性軟性麻痺は,主に子供や若者に影響し,長時間運動の弱さを示しました. エントロウイルスが検出されましたが,この珍しい神経症候群の正確な原因は不明です.
科学分野:
- 神経科学
- 感染症
- 公衆衛生の監視
背景:
- 北米ではポリオウイルスの根絶後の急性軟性麻痺 (AFP) の監視は限られている.
- カリフォルニア州では2012年以降,原因不明のAFP症例が増加していることが報告されています.
研究 の 目的:
- 脊髄運動ニューロン損傷によるAFPの発生率を決定する.
- これらのAFP症例の潜在的な原因を特定する.
主な方法:
- 脊髄運動ニューロンの関与 (放射線学的/神経生理学的証拠) を有するAFP患者のケースシリーズアプローチが用いられました.
- カリフォルニア州で2012年6月から2015年7月に収集したデータです.
- 脳脊髄液,血清,呼吸器/便のサンプルを検査する.
主要な成果:
- 59 件のAFPが確認された. 平均年齢は9歳, 主に子供と若者であった.
- 56人の患者で脊髄灰質のT2超強度がMRIで示され,そのうち43人が脳脊髄液の多細胞症であった.
- エンテロウイルスは,特にエンテロウイルスD68の発生時に検出された最も一般的な病原体 (15/45) でした. フォローアップ時に38/45人の患者で持続的な弱さが見られた.
結論:
- カリフォルニア州では,脊髄運動ニューロン損傷による希少だが独特なAFP症候群が観察された.
- 病因は不明で,主に長時間運動障害の子供や若者に影響する.
- この神経学的状態の原因を明らかにするためにさらなる調査が必要である.
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