文摘
客观的描述NMDAR脑炎的一个年轻的拉丁裔男性患者,另外的因素导致延迟的预防和诊断的医疗保健,这导致NMDAR脑炎的预防的情况下的发展。
背景青少年非法移民在美国面临的历史偏见和偏见,与医疗有关的延续差距和偏见。缺乏文化的了解实践中卫生保健工作者可以创建多个失去机会提供标准的护理实践,包括例行睾丸考试。与免疫疗法治疗NMDAR脑炎,有罪的肿瘤的切除当礼物,可以挽救生命。生殖细胞肿瘤协会的认可也再次意识到这样的肿瘤筛查的重要性。
设计/方法N / A。
结果案例:一位25岁男性移民从墨西哥到美国13岁了去医院癫痫持续状态的担忧。他过去的病史包括非典型发育迟缓十几岁年末开始。大成像作为一个舞台上腹部肿块被确认IIIC (pT1bN0M1bS2) NSGCT畸胎瘤(70% / 30%的精原细胞瘤)引起的肿瘤姑息性,未降到阴囊的睾丸。自主设置的不稳定的恶性肿瘤导致的评价和诊断,NMDAR脑炎。他的课被改变精神状态复杂,癫痫,交感风暴,orofacial肌张力障碍。肿瘤切除后,启动免疫疗法,病人表现出显著的恢复。
结论这个病人的预防保健是影响在多个时间点通过改变政治政策和缺乏文化通知实践,不可预知的中断可靠的获得医疗保健。承认保健差距让我们扩大我们的鉴别诊断,制定一个全面的方法,以填补空白。有效的沟通,将集中讨论在文化上敏感的框架,需要持续的教育临床医生对他们服务的人群,预防疾病,减少医疗差距。
脚注
披露:起重机博士没有披露。Jensen博士没有披露。刘博士的直系亲属成员的机构已收到NIH的研究支持。Abbatemarco博士没有披露。博士的山地没有披露。冬青Leydard没有披露。阁下已收到博士个人薪酬在500 - 4999美元的范围作为顾问西雅图遗传学。哲人博士的机构收到詹森的研究支持。哲人博士的机构已收到从阿斯特拉/西雅图遗传学研究支持。哲人博士的机构已经接到Exelixis)研究支持。 Dr. Miranda has nothing to disclose. Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for Clarion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ExpertConnect. The institution of Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for VielaBio. The institution of Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for Genentech. The institution of Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Clardy has received personal compensation in the range of $0-$499 for serving as a Consultant for GuidePoint. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from Alexion Pharma. The institution of Dr. Clardy has received research support from Sumaira Foundation for NMO. The institution of Dr. Clardy has received research support from Immune Deficiency Foundation. The institution of Dr. Clardy has received research support from Western Institute for Veteran Research. The institution of Dr. Clardy has received research support from NIH/NINDS. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel and Lodging with U of Iowa. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Speaker Honoraria for Grand Rounds with Barrow Neurological Institute.
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