大人の中枢神経系の原発性血管炎
Carlo Salvarani1, Robert D Brown, Gene G Hunder
1Unit of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy. salvarani.carlo@asmn.re.it
Lancet (London, England)
|May 12, 2012
まとめ
主要の中枢神経系 (CNS) 血管炎は,脳と脊髄に影響を与え,様々な神経学的症状を呈する. 早期診断と治療は,重篤な結果を防ぐために極めて重要です.
科学分野:
- 神経学 神経学とは
- 免疫学 免疫学とは
背景:
- 主要な中枢神経系 (CNS) 血管炎は,脳と脊髄に影響を与える希少なイディオパシー性炎症状態です.
- 一般的に50歳くらいの個人に発症し,頭痛,認知の変化,焦点の弱さ,脳卒中などの様々な神経学的症状を呈する.
研究 の 目的:
- 主要な中枢神経系血管炎の主要な側面を要約し,その提示,診断上の課題,および管理を含む.
- 効果的な治療と改善された患者のアウトカムのための早期認識の重要性を強調する.
主な方法:
- 主要の中枢神経系血管炎に関する既存の文献のレビュー.
- 神経イメージング (MRI),脳脊髄液分析,生検を含む診断基準の分析.
- 治療戦略と差異診断の議論.
主要な成果:
- 血清学的炎症マーカーは通常正常であり,脳脊髄液の異常は一般的です (80-90%).
- 正常な脳MRIは診断を不可能にしますが,CNS組織生検は決定的な診断検査です.
- アンジオグラフィーは頻繁に使用されますが,中程度の感度と特異性があります.
結論:
- 主要の中枢神経系血管炎の早期認識は,適切な介入に不可欠です.
- コルチコステロイドおよび潜在的に細胞毒性薬剤による治療は,重篤な神経学的後遺症を予防することができます.
- 主要の中枢神経系血管炎と,可逆性脳血管収縮症候群や二次性血管炎のような疾患を区別することは,非常に重要です.
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