2012-2015年加利福尼亚州的未知病因的急性软性髓炎
Keith Van Haren1, Patrick Ayscue2, Emmanuelle Waubant3
1Department of Neurology, Stanford University School of Medicine, Stanford, California2Division of Child Neurology, Lucile Packard Children's Hospital, Stanford, California.
JAMA
|January 1, 2016
概括
在加利福尼亚州发生的急性松病例主要影响儿童和年轻人, 虽然发现了肠道病毒,但这种罕见的神经综合征的确切原因仍未确定.
科学领域:
- 神经学
- 传染性疾病
- 公共卫生监测
背景情况:
- 在北美脊髓灰质炎根除后,对急性软性 (AFP) 的监测有限.
- 加利福尼亚州从2012年开始报告了未知病因的AFP病例的增加.
研究的目的:
- 确定脊柱运动神经元损伤的AFP发生率.
- 确定这些AFP病例的潜在原因.
主要方法:
- 对脊柱运动神经元受影响的AFP患者使用病例系列方法 (放射学/神经生理学证据).
- 在加利福尼亚从2012年6月到2015年7月收集的数据.
- 对脑脊液,血清和呼吸道/便样本进行感染病原体的实验室检测.
主要成果:
- 发现了59例AFP病例;中位数年龄为9岁,主要是儿童和年轻人.
- 在56名患者中,MRI显示脊髓灰质T2高强度;43名患者患有脑脊液多细胞瘤.
- 肠道病毒是检测到的最常见的病原体 (15/45),特别是在肠道病毒D68爆发期间. 在随访期间,38/45名患者表现出持续的衰弱.
结论:
- 在加利福尼亚州观察到一种罕见但明显的AFP综合征与脊髓运动神经元损伤.
- 病因仍未确定,主要影响儿童和年轻人长期运动衰弱.
- 需要进一步的研究来阐明这种神经疾病的原因.
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