www.scholarsresearchlibrary.com t Available online a Scholars Research Library Der Pharmacia Lettre, 2016, 8 (9):133-136 (http://scholarsresearchlibrary.com/archive.html) ISSN 0975-5071 USA CODEN: DPLEB4 133 Scholar Research Library Acute Necrotizing Encephalopathy of Childhood: A case report in Iran Ali Khajeh 1 , Ghasem Miri-Aliabad 1 , Afshin Fayyazi 2 , Hassan Askari* 3 and Sharzad Sarabandi 4 1 Department of Pediatric, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran 2 Pediatrician, Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan, Iran 3 Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran 4 Student of Health Education, Zahedan University of Medical Sciences, Zahedan, Iran _____________________________________________________________________________________________ ABSTRACT Acute necrotizing encephalopathy (ANE) of childhood is a rapidly progressive encephalopathy that can occur after common viral infections such as influenza and Para influenza in healthy children. ANE Was described for the first time in a Japanese child and since then there have been over 200 reports in the literature. Here we report the clinical and neuropathologic findings of an Iranian child with the acute necrotizing encephalopathy (ANE). Key words: Acute necrotizing encephalopathy, Childhood, Clinical Features _____________________________________________________________________________________________ INTRODUCTION In 1995 for the first time Acute necrotizing encephalopathy(ANE) proposed by Mizuguchi et al [1]. ANE mainly reported in the South East Asian countries including Japan, Taiwan, and Korea, Although sporadic cases have been reported worldwide [2]. The actual incidence of ANE is unclear; but, over than 240 cases from Asia, 5 from North America and 10 cases from Europe have been reported [3]. It is generally considered to be a Para infectious disease that is triggered mainly by viral infections such as mycoplasma, influenza virus, herpes simplex virus, and human herpes virus-6 [4, 5]. It is now believed that ANE is probably immune-mediated or metabolic. It has been reported that cytokines, such as tumor necrosis factor receptor-1(TNF-a), interleukin-1, and interleukin-6, could mediate the disease [6-8]. Clinical signs and symptoms of ANA suddenly occur, The clinical presentation is nonspecific; however, early encephalopathy after a febrile illness, increased levels of serum liver transaminases, diffuse, bilateral, symmetric high intensity signal on T2-weighted brain magnetic resonance imaging (MRI), edema, and apoptosis and necrosis of neurons without inflammation evident in brain microscopy makes the diagnosis of ANE likely [9,10]. The patient's mental status will change with or without Convulsion and then rapidly will go to a comatose state within a average of 24–72 hours from the onset of fever and upper respiratory symptoms . Mortality rates reach approximately30% [11] results largely from cardiorespiratory compromise or complications from mechanical ventilation [12], Less than 10% of patients fully recover[13] and over 25 percent of the survivors of this disease survivors develop substantial neurologic sequelae[9].