渐进性多焦点白血脑病,模仿脑血管炎爆发.
Sharafath Hussain Zahir Hussain1, Kehinde O Sunmboye2
1Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR.
Cureus
|July 31, 2023
概括
渐进性多焦点白内障 (PML) 是一种罕见的脑部感染,可能发生在免疫功能低下的患者中. 这一案例凸显了PML作为新出现的类似中风症状的患者的关键差异诊断.
科学领域:
- 神经免疫学 神经免疫学
- 传染性疾病 传染性疾病
- 神经学 神经学
背景情况:
- 一名68岁的妇女有原发性脑血管炎病史,出现了反复复发的神经症状.
- 该患者接受维护性阿扎西奥普林治疗,此前曾因血管炎而接受过利图西马布和环胺.
研究的目的:
- 在患有脑血管炎的患者中报告一种渐进的多焦点白内障 (PML) 病例,模仿中风复发.
- 强调在出现新的神经系统缺陷的免疫受损个体中考虑PML的重要性.
主要方法:
- 临床表现和神经学检查.
- 无对比计算断层扫描 (CT) 头部和磁共振成像 (MRI) 脑部.
- 脑脊液 (CSF) 聚合酶链反应 (PCR) 对于约翰·坎宁汉 (JC) 病毒的DNA.
主要成果:
- 最初的CT扫描显示没有急性神经学发现.
- 大脑MRI显示白质中的T2超强度,暗示PML.
- CSF PCR证实了JC病毒DNA的存在.
结论:
- 在患有类似中风症状的免疫受损患者中,PML应该是关键的差异诊断.
- 早期识别和诊断PML对于患有潜在自身免疫或免疫抑制疾病的患者的适当治疗至关重要.
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