文摘
客观的识别自身免疫性脑炎(AE)模拟和临床特征的文献报道。
背景最近的证据表明AE一样频繁的传染性脑炎增加了意识和检测免疫介导的神经损伤的原因。与这一主题相一致,几个出版物都集中在患者被诊断为AE最初被忽视。相反,AE仍然是一个罕见的诊断在临床实践中,开放的可能性症状,标志,和测试结果与其他病因是AE误认的。
设计/方法病例报告发表在PubMed在英文综述了04/2022。疑似病例在AE显然是谁的诊断检查期间或误诊包括在内。
结果总共45最终诊断患者不同于AE包括从40报告。平均年龄是52岁(范围5 - 86)年;30/45(67%)是男性。28例实现可能的标准AE(62%)、五定AE (11%), 12 (27%)。特征暗示AE急性/亚急性改变精神状态(从异常行为到昏迷),(82%);最近诊断为难治性癫痫持续状态(7%);CSF脑脊液细胞增多(42%)或寡克隆乐队(9%),和明显反应免疫治疗(38%)。在26日的情况下,成像与边缘的解剖分类脑炎、15有一个或多个皮层、皮层下T2-abnormalities脑膜的参与,一个脑干的介入,两人正常的核磁共振。在12个病人,临床神经无关自身抗体检测血清或脑脊液,包括迦得,Anti-Zic4, CASPR2, VGKC, anti-N-type钙通道抗体,anti-LGI1, GQ1B。我们确定了四种常见AE模仿类:肿瘤(15例)、传染病(9例),遗传疾病(9例)和神经退行性疾病患者(7)。 Five patients had other etiologies.
结论尽管有明确的临床诊断标准,AE包含典型的误诊的常见障碍和不太可能罕见的诊断。
脚注
披露:奥雷利亚纳摩尔诺小姐没有披露。天已收到博士个人薪酬在5000 - 9999美元的范围为Parabon Nanolabs担任顾问。天已收到博士个人薪酬制度在5000 - 9999美元的范围为礼来公司担任顾问。天已收到博士个人薪酬在500 - 4999美元的范围作为一个编辑,副主编,或编辑顾问委员会成员力学(EBSCO健康)。天已收到博士个人薪酬在10000 - 49999美元的范围为巴罗法作为专家证人。天博士ANI制药公司的股票。天已收到博士研究机构国立卫生研究院/ NIA的支持。天已收到博士研究的机构支持陈扎克伯格倡议。天已收到博士研究的机构阿尔茨海默氏症协会的支持。天已收到博士研究机构国立卫生研究院/研究所的支持。 The institution of Dr. Day has received research support from Horizon Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with American Academy of Neurology. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing Education, Inc. Dr. Day has a non-compensated relationship as a Clinical Director with AntiNMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities. Dr. Sechi has nothing to disclose. Dr. Lopez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Lopez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech.
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