Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019
A 45-year-old woman was hospitalized with severe coronavirus disease 2019 pneumonia. Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic ence...
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| Veröffentlicht in: | Internal Medicine 2024/04/15, Vol.63(8), pp.1167-1172 |
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| creator | Kawasaki, Juri Mato, Naoko Fujii, Hiroyuki Miura, Kumiko Mashiko, Takafumi Katayama, Shinshu Yamanouchi, Yoshitaka Sato, Miki Takasaki, Toshikazu Takigami, Ayako Hisata, Shu Nunomiya, Shin Hagiwara, Koichi Maemondo, Makoto |
| description | A 45-year-old woman was hospitalized with severe coronavirus disease 2019 pneumonia. Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic encephalopathies, and diffusion-weighted magnetic resonance imaging demonstrated high-intensity areas in the white matter with a cortex-sparing distribution, suggesting delayed post-hypoxic leukoencephalopathy. As a result of intensive cardiopulmonary support for a month, the neurological function gradually recovered. Based on the reversible clinical course noted in this patient, accurate diagnosis and persistent medical approaches are important for the management of coronavirus disease 2019-related delayed post-hypoxic leukoencephalopathy. |
| doi_str_mv | 10.2169/internalmedicine.1412-22 |
| format | Article |
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Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic encephalopathies, and diffusion-weighted magnetic resonance imaging demonstrated high-intensity areas in the white matter with a cortex-sparing distribution, suggesting delayed post-hypoxic leukoencephalopathy. As a result of intensive cardiopulmonary support for a month, the neurological function gradually recovered. Based on the reversible clinical course noted in this patient, accurate diagnosis and persistent medical approaches are important for the management of coronavirus disease 2019-related delayed post-hypoxic leukoencephalopathy.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.1412-22</identifier><identifier>PMID: 38296478</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Arrhythmia ; Cerebrospinal fluid ; coronavirus disease 2019 (COVID-19) ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; Cytokine storm ; delayed post-hypoxic leukoencephalopathy (DPHL) ; Diffusion Magnetic Resonance Imaging ; Disease Progression ; Female ; Humans ; Hypoxia ; Hypoxia - etiology ; Immunogenicity ; Leukoencephalopathies - diagnostic imaging ; Leukoencephalopathies - etiology ; Leukoencephalopathy ; Magnetic Resonance Imaging ; Middle Aged ; multiorgan failure ; Neuroimaging ; Patients ; Substantia alba</subject><ispartof>Internal Medicine, 2024/04/15, Vol.63(8), pp.1167-1172</ispartof><rights>2024 by The Japanese Society of Internal Medicine</rights><rights>2024. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c532t-860c115155289e44ed792a56b0c8907e261fe98842faccd03c3d52c346fe78e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38296478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawasaki, Juri</creatorcontrib><creatorcontrib>Mato, Naoko</creatorcontrib><creatorcontrib>Fujii, Hiroyuki</creatorcontrib><creatorcontrib>Miura, Kumiko</creatorcontrib><creatorcontrib>Mashiko, Takafumi</creatorcontrib><creatorcontrib>Katayama, Shinshu</creatorcontrib><creatorcontrib>Yamanouchi, Yoshitaka</creatorcontrib><creatorcontrib>Sato, Miki</creatorcontrib><creatorcontrib>Takasaki, Toshikazu</creatorcontrib><creatorcontrib>Takigami, Ayako</creatorcontrib><creatorcontrib>Hisata, Shu</creatorcontrib><creatorcontrib>Nunomiya, Shin</creatorcontrib><creatorcontrib>Hagiwara, Koichi</creatorcontrib><creatorcontrib>Maemondo, Makoto</creatorcontrib><title>Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>A 45-year-old woman was hospitalized with severe coronavirus disease 2019 pneumonia. Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic encephalopathies, and diffusion-weighted magnetic resonance imaging demonstrated high-intensity areas in the white matter with a cortex-sparing distribution, suggesting delayed post-hypoxic leukoencephalopathy. As a result of intensive cardiopulmonary support for a month, the neurological function gradually recovered. Based on the reversible clinical course noted in this patient, accurate diagnosis and persistent medical approaches are important for the management of coronavirus disease 2019-related delayed post-hypoxic leukoencephalopathy.</description><subject>Arrhythmia</subject><subject>Cerebrospinal fluid</subject><subject>coronavirus disease 2019 (COVID-19)</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>Cytokine storm</subject><subject>delayed post-hypoxic leukoencephalopathy (DPHL)</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Hypoxia - etiology</subject><subject>Immunogenicity</subject><subject>Leukoencephalopathies - diagnostic imaging</subject><subject>Leukoencephalopathies - etiology</subject><subject>Leukoencephalopathy</subject><subject>Magnetic Resonance Imaging</subject><subject>Middle Aged</subject><subject>multiorgan failure</subject><subject>Neuroimaging</subject><subject>Patients</subject><subject>Substantia alba</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkc9uEzEQxlcIREPhFZAlLly2-M-u1z6itAWkCCoFzpbrnU0cHHuxvYV9Ex4Xh4QcymXmML_vG818VYUIvqKEy3fWZ4heuz301lgPV6QhtKb0SbUgrJF1R1n7tFpgSURNS7moXqS0w5iJTtLn1QUTVPKmE4vq99puvB2s0d4ACgO6g5hsyuAzWs-l761B62kcQ8zIepS3gJbO-iJwaBmmmP6qrsHpGXp0F1Kut_MYfhXZCqbvAYrvuNUujDpvZ3QbnAs_rd-gNTxALGYhBq8fbJwSurYJdDGkmMiX1bNBuwSvTv2y-nZ783X5sV59-fBp-X5Vm5bRXAuODSEtaVsqJDQN9OVC3fJ7bITEHVBOBpBCNHTQxvSYGda31LCGD9AJIOyyenv0HWP4MUHKam-TAee0hzAlRSXluONtd0DfPEJ35QElhqQYbhsuJSO8UOJImRhSijCoMdq9jrMiWB3SU4_TU4f0FKVF-vq0YLovw7PwX1wF-HwEdinrDZwBHbM1Dv535kyJQzltOINmq6MCz_4Ateq6BQ</recordid><startdate>20240415</startdate><enddate>20240415</enddate><creator>Kawasaki, Juri</creator><creator>Mato, Naoko</creator><creator>Fujii, Hiroyuki</creator><creator>Miura, Kumiko</creator><creator>Mashiko, Takafumi</creator><creator>Katayama, Shinshu</creator><creator>Yamanouchi, Yoshitaka</creator><creator>Sato, Miki</creator><creator>Takasaki, Toshikazu</creator><creator>Takigami, Ayako</creator><creator>Hisata, Shu</creator><creator>Nunomiya, Shin</creator><creator>Hagiwara, Koichi</creator><creator>Maemondo, Makoto</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20240415</creationdate><title>Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019</title><author>Kawasaki, Juri ; 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| source | MEDLINE; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese; PubMed Central; PubMed Central Open Access |
| subjects | Arrhythmia Cerebrospinal fluid coronavirus disease 2019 (COVID-19) Coronaviruses COVID-19 COVID-19 - complications Cytokine storm delayed post-hypoxic leukoencephalopathy (DPHL) Diffusion Magnetic Resonance Imaging Disease Progression Female Humans Hypoxia Hypoxia - etiology Immunogenicity Leukoencephalopathies - diagnostic imaging Leukoencephalopathies - etiology Leukoencephalopathy Magnetic Resonance Imaging Middle Aged multiorgan failure Neuroimaging Patients Substantia alba |
| title | Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019 |
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