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Aetiology and Prognosis of Encephalitis in Korean Children: A Retrospective Single-Centre Study, 2005–2020

 Ahra Kim  ;  Minyoung Kim  ;  Jee Yeon Baek  ;  Ji Young Lee  ;  Se Hee Kim  ;  Ji-Man Kang  ;  Jong Gyun Ahn  ;  Hoon-Chul Kang 
 YONSEI MEDICAL JOURNAL, Vol.65(2) : 78-88, 2024-02 
Journal Title
Issue Date
Autoimmune Diseases of the Nervous System* / complications ; Bacteria ; Child ; Encephalitis* / diagnosis ; Encephalitis* / epidemiology ; Encephalitis* / etiology ; Hashimoto Disease* ; Humans ; Prognosis ; Republic of Korea / epidemiology ; Retrospective Studies
Encephalitis ; aetiology ; prognosis ; risk factor
Purpose: Encephalitis is a heterogeneous syndrome that occurs in childhood and is not rare. However, epidemiological studies of encephalitis based on the International Encephalitis Consortium (ICS) and expert recommendations are lacking. We investigated the aetiology and prognosis of encephalitis in Korean children.

Materials and Methods: This retrospective study included children aged <19 years hospitalised for encephalitis at Severance Children’s Hospital between 2005 and 2020. The 2013 ICS criteria were used to diagnose encephalitis, and causality was classified according to the site from which the specimen was obtained. Neurological sequelae were categorised using the modified Rankin Scale (mRS) score.

Results: In total, 551 children were included, with 7% classified as possible, 77% as probable, and 15% as proven cases. A cause was identified in 42% of the cases (n=222), with viruses being the most common (42%), followed by bacteria (38%) and autoimmune encephalitis (12%). In cases of proven/probable encephalitis (n=65), bacteria accounted for 52%, followed by viruses (25%) and au toimmune encephalitis (22%). In cases with a single pathogen, the anti-N-methyl-D-aspartate receptor autoantibody (n=14) was the most common, followed by Group B streptococcus (n=13), herpes simplex virus (n=11), enterovirus (n=4), and others. Approxi mately 37% of patients had severe sequelae (mRS score ≥3) at discharge, which decreased to 31% 6 months after discharge.

Conclusion: This large-scale study showed that autoimmune and infectious causes accounted for a significant proportion of en cephalitis in Korean children. Further studies are needed to determine whether early targeted treatment following early diagnosis leads to a favourable prognosis in these populations.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ji-Man(강지만) ORCID logo https://orcid.org/0000-0002-0678-4964
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Se Hee(김세희) ORCID logo https://orcid.org/0000-0001-7773-1942
Baek, Jee Yeon(백지연) ORCID logo https://orcid.org/0000-0001-6674-8618
Ahn, Jong Gyun(안종균) ORCID logo https://orcid.org/0000-0001-5748-0015
Lee, Ji Young(이지영)
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