抗N-甲基-d-酸盐受体脑炎之前脑膜炎持续长达60天
Naoki Yamahara1, Nobuaki Yoshikura1, Akira Takekoshi1
1Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan.
Journal of neuroimmunology
|August 12, 2023
概括
长期的脑膜炎可能表明N-甲基-D-酸盐受体 (NMDAR) 脑炎. 两例病例显示长期脑膜炎之前的抗NMDAR脑炎,这表明应该考虑在差异诊断.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 抗N-甲基-D-酸盐受体 (NMDAR) 脑炎是一种自身免疫性疾病.
- 脑膜炎可以在抗NMDAR脑炎之前发生,但长期脑膜炎不常被讨论.
- 这些病例的临床过程和诊断考虑需要进一步阐明.
研究的目的:
- 在长期脑膜炎后报告两例抗NMDAR脑炎.
- 为了突出这些患者前脑膜炎的延长持续时间.
- 强调在持续性脑膜炎的差异诊断中考虑抗NMDAR脑炎的重要性.
主要方法:
- 两名患有抗NMDAR脑炎的患者的病例报告介绍.
- 对临床病史,先前脑膜炎的持续时间和治疗结果的审查.
- 通过适当的调查,排除瘤原因.
主要成果:
- 两名患者在脑膜炎后出现了反NMDAR脑炎,分别持续60天和22天.
- 两位患者均表现出静脉注射甲基前尼索隆和等离子体酶的改善.
- 在这两种情况下都没有发现潜在的瘤.
结论:
- 长时间的脑膜炎可能是抗NMDAR脑炎的前兆.
- 在报告的病例中,脑膜炎的持续时间明显超过典型描述的时间.
- 应将抗NMDAR脑炎纳入长期脑膜炎患者的差异诊断.
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