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[Weston Hurst acute haemorrhagic leukoencephalitis. Neuropathological study of one case].

AbstractINTRODUCTION:
Acute hemorrhagic leukoencephalitis (AHL), or Hurst disease is a rare, usually fatal, disease, probably due to an autoimmune cross reaction against myelin antigens present in the central nervous system, and which forms a spectrum of post infeccious demyelinating diseases with acute disseminated encephalomyelitis.
CASE REPORT:
The patient was a 21 year old female who presented with an acute encephalopathy and generalized seizures following a 15 day febrile syndrome attributed to amygdalitis; a laboratory work up, including CSF, was non diagnostic, and a brain CT scan revealed diffuse cerebral edema. After 12 days the patient died from nosocomial pneumonia and multi organ failure; neuropathological examination of the brain confirmed the diagnosis of Hurst acute hemorrhagic leukoencephalitis, with a weak perilesional inflammatory reaction, unlike the usual picture in AHL.
DISCUSSION:
AHL should be a part of the differential diagnosis of acute encephalopathic diseases, particularly if preceded by systemic infections. The atypical laboratory findings, and the impossibilty of performing a brain MRI were obstacles to the diagnosis in this case. The relative paucity of the perivascular infiltrate is an atypical finding, and could be due to apoptotic clearance of the inflammatory cells, as has been described in other autoimmune demyelinating diseases.
AuthorsP Fontoura, A Mendes, M Correira, M Melo-Pires
JournalRevista de neurologia (Rev Neurol) 2002 Aug 16-31 Vol. 35 Issue 4 Pg. 328-31 ISSN: 0210-0010 [Print] Spain
Vernacular TitleLeucoencefalitis aguda hemorrágica de Weston Hurst. Estudio neuropatológico de un caso.
PMID12235562 (Publication Type: Case Reports, English Abstract, Journal Article)
Topics
  • Adult
  • Fatal Outcome
  • Female
  • Humans
  • Leukoencephalitis, Acute Hemorrhagic (diagnosis, pathology, physiopathology)

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