Cerebral Magnetic Resonance Imaging Findings in Adults with Haemolytic Uraemic Syndrome Following an Infection with Escherichia coli, Subtype O104:H4
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Cerebral Magnetic Resonance Imaging Findings in Adults with Haemolytic Uraemic Syndrome Following an Infection with Escherichia coli, Subtype O104:H4. / Löbel, U; Eckert, B; Simova, O; Meier-Cillien, M; Kluge, S; Gerloff, C; Röther, J; Magnus, T; Fiehler, J.
in: CLIN NEURORADIOL, Jahrgang 24, Nr. 2, 01.06.2014, S. 111-9.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Cerebral Magnetic Resonance Imaging Findings in Adults with Haemolytic Uraemic Syndrome Following an Infection with Escherichia coli, Subtype O104:H4
AU - Löbel, U
AU - Eckert, B
AU - Simova, O
AU - Meier-Cillien, M
AU - Kluge, S
AU - Gerloff, C
AU - Röther, J
AU - Magnus, T
AU - Fiehler, J
PY - 2014/6/1
Y1 - 2014/6/1
N2 - PURPOSE: Infections with Enterohaemorrhagic Escherichia coli typically occur in children causing haemolytic uraemic syndrome (HUS) and neurological symptoms in 20-50 %. Little information is available on the morphology of brain manifestations in adults. The purpose of this study was to identify a characteristic magnetic resonance imaging (MRI) pattern during the outbreak of a novel mutation of Escherichia coli O104:H4.METHODS: Patients were recruited from two hospitals between May and July 2011. The MRI protocol included standard anatomical, diffusion-weighted, and susceptibility-sensitive sequences.RESULTS: A total of 104 MRIs of 57 (32 female, 25 male) patients (mean 45.5 ± 18.4 years) showed abnormal signal intensity on 51 MRIs (49 %). Bilateral thalamus (39 %), bilateral pons (35 %), centrum semiovale and splenium of corpus callosum (33 %) were most often involved. Acute lesions were reversible in 81 % of cases. There was no statistically significant association between symptom onset and the MRI findings (P = 0.2).CONCLUSIONS: Neuroimaging findings in this adult patient cohort were non-specific and similar to previous findings in children. A characteristic neuroimaging pattern of an infection with Escherichia coli O104:H4 was not identified. However, bilateral symmetric T2 hyperintense lesions of the thalami and dorsal pons characterized by restricted diffusion suggest a metabolic toxic effect of the disease on the brain.
AB - PURPOSE: Infections with Enterohaemorrhagic Escherichia coli typically occur in children causing haemolytic uraemic syndrome (HUS) and neurological symptoms in 20-50 %. Little information is available on the morphology of brain manifestations in adults. The purpose of this study was to identify a characteristic magnetic resonance imaging (MRI) pattern during the outbreak of a novel mutation of Escherichia coli O104:H4.METHODS: Patients were recruited from two hospitals between May and July 2011. The MRI protocol included standard anatomical, diffusion-weighted, and susceptibility-sensitive sequences.RESULTS: A total of 104 MRIs of 57 (32 female, 25 male) patients (mean 45.5 ± 18.4 years) showed abnormal signal intensity on 51 MRIs (49 %). Bilateral thalamus (39 %), bilateral pons (35 %), centrum semiovale and splenium of corpus callosum (33 %) were most often involved. Acute lesions were reversible in 81 % of cases. There was no statistically significant association between symptom onset and the MRI findings (P = 0.2).CONCLUSIONS: Neuroimaging findings in this adult patient cohort were non-specific and similar to previous findings in children. A characteristic neuroimaging pattern of an infection with Escherichia coli O104:H4 was not identified. However, bilateral symmetric T2 hyperintense lesions of the thalami and dorsal pons characterized by restricted diffusion suggest a metabolic toxic effect of the disease on the brain.
U2 - 10.1007/s00062-013-0231-0
DO - 10.1007/s00062-013-0231-0
M3 - SCORING: Journal article
C2 - 23811994
VL - 24
SP - 111
EP - 119
JO - CLIN NEURORADIOL
JF - CLIN NEURORADIOL
SN - 1869-1439
IS - 2
ER -