Diagnostic odyssey of acute disseminated encephalomyelitis in children

Abstract We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time betwe...

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Autores principales:	Yoko Takahashi, Itaru Hayakawa, Yuichi Abe
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4d27934301bd431a8ca1b5859aa588e2
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spelling	oai:doaj.org-article:4d27934301bd431a8ca1b5859aa588e22021-11-14T12:21:14ZDiagnostic odyssey of acute disseminated encephalomyelitis in children10.1038/s41598-021-01519-52045-2322https://doaj.org/article/4d27934301bd431a8ca1b5859aa588e22021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01519-5https://doaj.org/toc/2045-2322Abstract We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time between symptom onset and ADEM diagnosis), physicians’ delay (between the first medical visit and ADEM diagnosis), and patients’ delay (between symptom onset and the first medical visit) were analysed. Thirty ADEM patients were identified, including 16 (54%) with neurological deficits at discharge. Overall, physicians’, and patients’ delays were 9 (interquartile range [IQR] 6–20.5), 5.5 (IQR 3–14), and 4 (IQR 2–8) days, respectively. Overall delay was significantly associated with physicians’ delay, but not with patients’ delay. There were 61 misdiagnoses among 25 (83%) patients, while 5 (17%) were diagnosed correctly at the first visit. The misdiagnoses of common respiratory and gastrointestinal infection and aseptic meningitis were associated with overall and/or physicians’ delay. Later onset of specific neurological features suggestive of ADEM was associated with all three diagnostic delays. A unique diagnostic odyssey exists in ADEM. Several clinical risk factors were associated with the diagnostic delay.Yoko TakahashiItaru HayakawaYuichi AbeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yoko Takahashi Itaru Hayakawa Yuichi Abe Diagnostic odyssey of acute disseminated encephalomyelitis in children
description	Abstract We aimed to determine whether acute disseminated encephalomyelitis (ADEM) diagnosis in children is delayed, and if so, to identify the clinical risk factors of delayed diagnosis. Standardised data were collected from children with ADEM from 2003 to 2020. Overall diagnostic delay (time between symptom onset and ADEM diagnosis), physicians’ delay (between the first medical visit and ADEM diagnosis), and patients’ delay (between symptom onset and the first medical visit) were analysed. Thirty ADEM patients were identified, including 16 (54%) with neurological deficits at discharge. Overall, physicians’, and patients’ delays were 9 (interquartile range [IQR] 6–20.5), 5.5 (IQR 3–14), and 4 (IQR 2–8) days, respectively. Overall delay was significantly associated with physicians’ delay, but not with patients’ delay. There were 61 misdiagnoses among 25 (83%) patients, while 5 (17%) were diagnosed correctly at the first visit. The misdiagnoses of common respiratory and gastrointestinal infection and aseptic meningitis were associated with overall and/or physicians’ delay. Later onset of specific neurological features suggestive of ADEM was associated with all three diagnostic delays. A unique diagnostic odyssey exists in ADEM. Several clinical risk factors were associated with the diagnostic delay.
format	article
author	Yoko Takahashi Itaru Hayakawa Yuichi Abe
author_facet	Yoko Takahashi Itaru Hayakawa Yuichi Abe
author_sort	Yoko Takahashi
title	Diagnostic odyssey of acute disseminated encephalomyelitis in children
title_short	Diagnostic odyssey of acute disseminated encephalomyelitis in children
title_full	Diagnostic odyssey of acute disseminated encephalomyelitis in children
title_fullStr	Diagnostic odyssey of acute disseminated encephalomyelitis in children
title_full_unstemmed	Diagnostic odyssey of acute disseminated encephalomyelitis in children
title_sort	diagnostic odyssey of acute disseminated encephalomyelitis in children
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4d27934301bd431a8ca1b5859aa588e2
work_keys_str_mv	AT yokotakahashi diagnosticodysseyofacutedisseminatedencephalomyelitisinchildren AT itaruhayakawa diagnosticodysseyofacutedisseminatedencephalomyelitisinchildren AT yuichiabe diagnosticodysseyofacutedisseminatedencephalomyelitisinchildren
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Diagnostic odyssey of acute disseminated encephalomyelitis in children

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