Marked elevation of interleukin-6 in mild encephalopathy with a reversible splenial lesion (MERS) associated with acute focal bacterial nephritis caused by Enterococcus faecalis |
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Authors: | Hiroshi Kometani Masao KawataniGenrei Ohta Shintaro OkazakiKazumasa Ogura Motoko YasutomiAkihiko Tanizawa Yusei Ohshima |
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Affiliation: | Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan |
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Abstract: | This report describes two cases of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) associated with acute focal bacterial nephritis (AFBN). The patients, who presented with fever and delirious behavior, exhibited hyponatremia and markedly elevated interleukin (IL)-6 in cerebrospinal fluid (CSF) and serum. Enterococcus faecalis was detected in the urine culture. After ampicillin treatment, their consciousness improved without neurological sequelae. Moreover, a diffusion-weighted MRI abnormality, i.e., intensified signals in splenium of the corpus callosum, disappeared. MERS is a possible complication of AFBN. Elevated CSF IL-6 levels suggest that remote activation of intracerebral immune response through the immune–neuroendocrine pathway might play an important role in the pathophysiology of MERS. |
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Keywords: | Encephalitis Encephalopathy Splenium Corpus callosum Acute focal bacterial nephritis Cytokine |
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