Evidence map›Paper›PMID 30316638›Full record

ArticleEuropean journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society2019

CSF neopterin, a useful biomarker in children presenting with influenza associated encephalopathy?

Emma Macdonald-Laurs, Archana Koirala, Philip N Britton, William Rawlinson, Chee Chung Hiew, Jocelynne Mcrae, Russell C Dale, Cheryl Jones, Kristine Macartney, Brendan McMullan and 1 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Emma Macdonald-LaursSydney Children's Hospital Network (SCHN), Australia; The University of New South Wales, Australia. Electronic address: emma.macdonaldlaurs@health.nsw.gov.au.
Archana KoiralaSydney Children's Hospital Network (SCHN), Australia; The University of New South Wales, Australia.
Philip N BrittonSydney Children's Hospital Network (SCHN), Australia; The University of Sydney, Discipline of Child and Adolescent Health, Australia.
William RawlinsonNSW Health Pathology, Australia.
Chee Chung HiewSydney Children's Hospital Network (SCHN), Australia; Prince of Wales Hospital, Sydney, Australia.
Jocelynne McraeSydney Children's Hospital Network (SCHN), Australia.
Russell C DaleSydney Children's Hospital Network (SCHN), Australia; The University of Sydney, Discipline of Child and Adolescent Health, Australia.
Cheryl JonesSydney Children's Hospital Network (SCHN), Australia; The University of Sydney, Discipline of Child and Adolescent Health, Australia; The Royal Children's Hospital, Melbourne, Australia; The University of Melbourne, Department of Paediatrics, Australia.
Kristine MacartneySydney Children's Hospital Network (SCHN), Australia; The University of Sydney, Discipline of Child and Adolescent Health, Australia.
Brendan McMullanSydney Children's Hospital Network (SCHN), Australia; The University of New South Wales, Australia.
Sekhar PillaiSydney Children's Hospital Network (SCHN), Australia; The University of New South Wales, Australia.
The University of Sydney · AUUNSW Sydney · AUNew South Wales Department of Health · AUPrince of Wales Hospital · AUSydney Children’s Hospitals Network · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeurological complications of influenza cause significant disease in children. Central nervous system inflammation, the presumed mechanism of influenza-associated encephalopathy, is difficult to detect. Characteristics of children presenting with severe neurological complications of influenza, and potential biomarkers of influenza-associated encephalopathy are described.

methodsA multi-center, retrospective case-series of children with influenza and neurological complications during 2017 was performed. Enrolled cases met criteria for influenza-associated encephalopathy or had status epilepticus. Functional outcome at discharge was compared between groups using the Modified Rankin Scale (mRS).

resultsThere were 22 children with influenza studied of whom 11/22 had encephalopathy and 11/22 had status epilepticus. Only one child had a documented influenza immunization. The biomarker CSF neopterin was tested in 10/11 children with encephalopathy and was elevated in 8/10. MRI was performed in all children with encephalopathy and was abnormal in 8 (73%). Treatment of children with encephalopathy was with corticosteroids or intravenous immunoglobulin in 9/11 (82%). In all cases oseltamivir use was low (59%) while admission to the intensive care unit was frequent (14/22, 66%). Clinical outcome at discharge was moderate to severe disability (mRS score > 2) in the majority of children with encephalopathy (7/11, 64%), including one child who died. Children with status epilepticus recovered to near-baseline function in all cases.

conclusionRaised CSF neopterin was present in most cases of encephalopathy, and along with diffusion restriction on MRI, is a useful diagnostic biomarker. Lack of seasonal influenza vaccination represents a missed opportunity to prevent illness in children, including severe neurological disease.

Indexed as

AdolescentBiomarkersBrain DiseasesChildChild, PreschoolFemaleHumansInfantInfluenza, HumanMagnetic Resonance ImagingMaleNeopterinRetrospective StudiesBiomarkersNeopterinEncephalitisInfluenzaInfluenza-associated encephalitisMagnetic resonance imagingNeopterinNeuroinflammationStatus epilepticus

Identifiers

PMID30316638
PMCPMC7128712
OpenAlexW2894495778

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.