渐进的多焦点白血脑病与卡巴马西平诱导的免疫功能障碍和卡巴马西平停止后的恢复相关
Sarah Perrott1, Qaisar Imran Khan2, Carl E Counsell3
1School of Medicine Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
BMJ case reports
|July 7, 2023
概括
药物卡巴马泽平与轻度免疫功能障碍患者的渐进性多焦点白内障病 (PML) 有关. 停止服用药物导致PML的解决和免疫恢复.
科学领域:
- 神经免疫学 神经免疫学
- 神经学 神经学
- 传染性疾病 传染性疾病
背景情况:
- 的治疗可能涉及具有潜在免疫效应的药物.
- 渐进性多焦点白内障 (PML) 是一种罕见的,严重的中枢神经系统脱髓化疾病.
- 药物诱导的免疫抑制是PML等机会性感染的已知危险因素.
研究的目的:
- 调查卡巴马西平使用与逐渐多焦点白内障病 (PML) 的发展之间潜在的联系.
- 探索免疫功能障碍在与卡巴马西相关的PML中的作用.
- 评估药物戒断对PML解决和免疫复合的影响.
主要方法:
- 一个患有的病人接受了卡巴马西平治疗,出现了小脑综合征的病例报告.
- 连续磁共振成像 (MRI) 用于评估大脑病变.
- 脑脊液 (CSF) 分析用于病原体检测和免疫标记.
- 药物戒断后对免疫参数 (淋巴细胞计数,免疫球蛋白水平) 的监测.
主要成果:
- 患者出现了快速进展的小脑综合征,特征性MRI发现表明PML.
- 在CSF中发现的John Cunningham病毒 (JCV) DNA证实了PML;初始的CSF分析结果是正常的.
- 低甘球蛋白血症和淋巴衰竭是免疫功能障碍的唯一指标.
- 停止卡巴马西平导致免疫参数的正常化和PML的解决,临床恢复良好.
结论:
- 卡巴马西平可能会诱导长时间的轻度免疫抑制,增加易感个体的PML风险.
- 卡巴马西取消后的免疫复制可以在没有特定的抗病毒治疗的情况下导致PML的解决.
- 抗药对免疫功能的影响需要进一步研究患者感染风险.
更多相关视频
08:47Induction of Experimental Autoimmune Encephalomyelitis in Mice and Evaluation of the Disease-dependent Distribution of Immune Cells in Various Tissues
Published on: May 8, 2016
23.8K
10:50Visualizing Impairment of the Endothelial and Glial Barriers of the Neurovascular Unit during Experimental Autoimmune Encephalomyelitis In Vivo
Published on: March 26, 2019
7.8K
相关概念视频
01:20Antiepileptic Drugs: Potassium Channel Activators
215
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
215
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
467
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
467
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
350
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
350
01:14Antiepileptic Drugs: Glutamate Antagonists
427
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
427
01:13Seizures: Classification
436
Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
436
01:24Arteries of the Lower Limbs
217
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
217