PMID- 20051019
OWN - NLM
STAT- MEDLINE
DCOM- 20101112
LR  - 20100721
IS  - 1440-1789 (Electronic)
IS  - 0919-6544 (Linking)
VI  - 30
IP  - 4
DP  - 2010 Aug
TI  - Dual pathology in Rasmussen's encephalitis: a study of seven cases and review of 
      the literature.
PG  - 381-91
LID - 10.1111/j.1440-1789.2009.01079.x [doi]
AB  - Dual pathology has previously been reported in less than 10% of cases of 
      Rasmussen's encephalitis (RE). Given the rarity of RE, it appears unlikely that 
      dual pathology in RE is merely a coincidence. We therefore reviewed all cases of 
      RE experienced in our institution to assess for an additional/associated 
      pathology. A total of seven patients with RE were identified in our archives. 
      Seven children (4 boys and 3 girls, age range: 3-16 years, mean: 9.5 years) with 
      medically refractory epilepsy underwent surgical resection for intractable 
      seizures. The surgical specimens were examined with routine neurohistological 
      techniques, and immunohistochemistry was performed with an extensive panel of 
      antibodies for viruses, lymphocytes, microglia/macrophages, human leukocyte 
      antigen (HLA)-DR, astrocytes, and neurons. Relevant literature was reviewed. 
      Microscopically, all seven cases demonstrated the inflammatory pathology of RE in 
      the cortex and white matter with leptomeningeal and perivascular lymphocytic 
      infiltration, microglial nodules with/without neuronophagia, neuronal loss and 
      gliosis. The HLA-DR antibody was extremely helpful in highlighting the extent of 
      microglial cell proliferation/activation that was not appreciable with standard 
      histology. An unexpected finding in all seven cases was the presence of cortical 
      dysplasia. In our series of seven cases, there was co-occurrence of the 
      inflammatory/destructive pathology of RE with malformative/dysplastic features in 
      cortical architecture in 100% of cases, raising questions about the possible 
      relationships between the two entities. Awareness of the possibility of dual 
      pathology in RE is important for clinical and pathological diagnosis, and may 
      affect the management and outcome of these patients. Immunohistochemistry is very 
      helpful to make a definitive diagnosis of both pathologies.
FAU - Takei, Hidehiro
AU  - Takei H
AD  - Department of Pathology, The Methodist Hospital, Houston, Texas, USA. 
      takei327@aol.com
FAU - Wilfong, Angus
AU  - Wilfong A
FAU - Malphrus, Amy
AU  - Malphrus A
FAU - Yoshor, Daniel
AU  - Yoshor D
FAU - Hunter, Jill V
AU  - Hunter JV
FAU - Armstrong, Dawna L
AU  - Armstrong DL
FAU - Bhattacharjee, Meenakshi B
AU  - Bhattacharjee MB
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20091228
PL  - Australia
TA  - Neuropathology
JT  - Neuropathology : official journal of the Japanese Society of Neuropathology
JID - 9606526
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Encephalitis/*complications/immunology/*pathology
MH  - Female
MH  - HLA-DR Antigens/immunology
MH  - Humans
MH  - Immunohistochemistry
MH  - Male
MH  - Malformations of Cortical Development/*complications/*pathology
EDAT- 2010/01/07 06:00
MHDA- 2010/11/13 06:00
CRDT- 2010/01/07 06:00
PHST- 2010/01/07 06:00 [entrez]
PHST- 2010/01/07 06:00 [pubmed]
PHST- 2010/11/13 06:00 [medline]
AID - NEU1079 [pii]
AID - 10.1111/j.1440-1789.2009.01079.x [doi]
PST - ppublish
SO  - Neuropathology. 2010 Aug;30(4):381-91. doi: 10.1111/j.1440-1789.2009.01079.x. 
      Epub 2009 Dec 28.