Clinical and genetic features of acute encephalopathy in children taking theophylline.

Abstract

BACKGROUND:

Theophylline has recently been suspected as a risk factor of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), although there has been no systematic study on the relationship between acute encephalopathy in children taking theophylline (AET) and AESD.

METHODS:

We recruited 16 Japanese patients (11 male and 5 female, median age of 2 years and 7 months) with AET from 2008 to 2013. We evaluated their clinical features, such as the duration of first seizure, biphasic clinical course and cranial CT/MRI imaging and compared them with those of AESD. We analyzed the polymorphisms or mutations of genes which are associated with AESD.

RESULTS:

Clinically, 12 patients had neurological and/or radiological features of AESD. Only one patient died, whereas all 15 surviving patients were left with motor and/or intellectual deficits. Genetically, 14 patients had at least one of the following polymorphisms or mutations associated with AESD: thermolabile variation of the carnitine palmitoyltransferase 2 (CPT2) gene, polymorphism causing high expression of the adenosine receptor A2A (ADORA2A) gene, and heterozygous missense mutation of the voltage gated sodium channel 1A (SCN1A) and 2A (SCN2A) gene.

CONCLUSIONS:

Our results demonstrate that AET overlaps with AESD, and that AET is a multifactorial disorder sharing a genetic background with AESD.

• Authors: Makiko Saitoh, Mayu Shinohara, Atsushi Ishii, Yukiko Ihara, Shinichi Hirose, Masashi Shiomi, Hisashi Kawawaki, Masaya Kubota, Takanori Yamagata, Akie Miyamoto, Gaku Yamanaka, Kaoru Amemiya, Kenjiro Kikuchi, Atsushi Kamei, Manami Akasaka, Yuki Anzai, Masashi Mizuguchi
• Journal: Brain & development (Brain Dev) Vol. 37 Issue 5 Pg. 463-70 (May 2015) ISSN: 1872-7131 [Electronic] Netherlands
• PMID: 25156649 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Chemical References

• Anti-Asthmatic Agents
• NAV1.1 Voltage-Gated Sodium Channel
• NAV1.2 Voltage-Gated Sodium Channel
• Receptor, Adenosine A2A
• SCN1A protein, human
• SCN2A protein, human
• Theophylline

Topics

• Acute Disease
• Anti-Asthmatic Agents (administration & dosage, adverse effects)
• Brain Diseases (chemically induced, genetics, pathology)
• Case-Control Studies
• Child, Preschool
• Female
• Genetic Predisposition to Disease
• Humans
• Infant
• Magnetic Resonance Imaging
• Male
• Mutation, Missense
• NAV1.1 Voltage-Gated Sodium Channel (genetics)
• NAV1.2 Voltage-Gated Sodium Channel (genetics)
• Receptor, Adenosine A2A (genetics)
• Theophylline (administration & dosage, adverse effects)
• Tomography, X-Ray Computed