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Acute bilateral striatal necrosis with rotavirus gastroenteritis and inborn metabolic predisposition

Published online by Cambridge University Press:  12 May 2005

Santosh Mordekar
Affiliation:
Department of Paediatric Neurology, Queen's Medical Centre, Nottingham, UK.
Tim Jaspan
Affiliation:
Department of Radiology, Queen's Medical Centre, Nottingham, UK.
Mark Sharrard
Affiliation:
Department of Metabolic Medicine, Sheffield Children's Hospital, Sheffield, UK.
Richard Morton
Affiliation:
Department of Paediatrics, Derbyshire Children's Hospital, Derby, UK.
William P Whitehouse
Affiliation:
Academic Division of Child Health, University of Nottingham, Nottingham, UK.
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Abstract

We present a 9-month-old male with acute rotavirus gastroenteritis who developed an acute encephalopathy with focal seizures and developmental regression. Magnetic resonance imaging showed bilateral striatal necrosis and raised glutarylcarnitine levels on tandem mass spectrometry of a (crisis) blood spot, and chromatography of organic acids revealed increased urinary excretion of dicarboxylic acid. Skin biopsy demonstrated a partial decrease in glutaryl-CoA dehydrogenase activity. The case was not typical for either rotavirus encephalitis/rotavirus-associated encephalopathy or for glutaric aciduria type I. The patient has developmental delay and continues to receive physiotherapy, speech therapy, and local developmental follow-up.

Type
Case Report
Copyright
© 2005 Mac Keith Press

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