The Da Nang Hospital for Women and Children in the namesake city on Wednesday reported successfully treating an eight-year-old boy with autoimmune encephalitis, a rare condition never documented in Vietnamese medical literature before.

The child patient, eight-year-old H.T.T. from neighboring Quang Nam Province, was admitted to the Da Nang Hospital for Women and Children in a state of convulsions and coma, despite having a previously healthy history. 

Two days before admission, he experienced symptoms of headache and nausea.

Following that, he experienced whole-body convulsions, followed by slow responsiveness, intermittent seizures, difficulty breathing, and eventually slipped into a coma.

T. received critical care at the pediatric emergency and intensive care unit, where he underwent mechanical ventilation, treatment for cerebral edema, and immediate specialist consultations to diagnose the cause of his condition.

Dr. Ha Quang Chau from the department said treating T. was challenging, given the sudden onset and unclear diagnosis. 

Upon admission, T. also developed small blisters on his lower abdomen, which gradually increased in size and spread to his chest, lower abdomen, genitals, and limbs.

Suspecting a rare autoimmune condition related to blistering disorders, the pediatric emergency and intensive care unit, together with neurologists and dermatologists from Da Nang Dermatology and Venereology Hospital, promptly collaborated to diagnose T.’s case.

They eventually identified it as autoimmune encephalitis associated with bullous pemphigoid disease.

Following the diagnosis, T. underwent intravenous Methylprednisolone immunotherapy, administered at a dosage of 30mg per kg per day for five days. 

After more than two weeks of treatment, T. showed remarkable improvement from a deep coma with no reflexes and a poor prognosis to being able to communicate with his parents, breathe independently, and resume eating and walking without assistance. 

The skin blisters healed, leaving no scars and showing no signs of recurrence.

Dr. Chau emphasized the importance for parents to seek medical attention promptly if their children exhibit symptoms such as fever and skin lesions like rashes or blisters, to facilitate timely diagnosis and treatment and prevent complications.

Unprecedented in Vietnam

Dr. Tran Long Quan, deputy head of the pediatric emergency and intensive care unit at the Da Nang Hospital for Women and Children, explained that bullous pemphigoid is an autoimmune bullous skin disease found beneath the epidermis, typically affecting adults aged 60-80, although it can occur rarely in children.

According to medical literature, only four cases of autoimmune encephalitis associated with autoimmune bullous disease have been documented worldwide in the past two decades, primarily in adults and not previously reported in Vietnam.

“Pemphigoid usually follows a benign and chronic course with intermittent recurrences,” Dr. Quan noted. 

“However, autoimmune encephalitis related to autoimmune bullous disease, if not promptly diagnosed and treated, can lead to severe brain damage, potentially resulting in death or neurological complications.”

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