错误诊断的渐进性多焦点白内障 (PML) 在一个艾滋病毒阴性患者与白内障狼:一个病例报告
Aliaa Mousa1, Muhammad Humayoun Rashid1,2, Kudret Arslan1
1Internal Medicine, Capital Health Regional Medical Center, Trenton, USA.
Cureus
|August 18, 2023
概括
渐进性多焦点白内障 (PML) 是一种罕见的大脑疾病,诊断可能具有挑战性,特别是在非艾滋病毒患者中. 早期检测John Cunningham (JC) 病毒DNA对于更好的结果至关重要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 渐进性多焦点白内障 (PML) 是一种罕见的中枢神经系统脱髓化疾病.
- 自20世纪80年代以来,PML的发病率有所增加,通常与免疫抑制有关,特别是在感染艾滋病毒的人群中.
- 在非艾滋病毒患者中,诊断可能具有挑战性,需要高度的临床怀疑和先进的诊断方法.
研究的目的:
- 在没有其他典型风险因素的光盘性狼患者中报告罕见的PML病例.
- 突出诊断方面的挑战以及在类似情况下临床警的重要性.
- 为了解PML在特定患者群体中的理解作出贡献.
主要方法:
- 一个64岁的女性病例报告,她30年来患有圆盘性狼.
- 临床表现与复发的神经缺陷最初被误诊为中风.
- 诊断工作包括对John Cunningham (JC) 病毒DNA聚合酶链反应 (PCR) 的脑脊液 (CSF) 分析.
主要成果:
- 随着时间的推移,患者呈现出各种神经学缺陷.
- 脑脊液分析显示了阳性约翰·坎宁汉 (JC) 病毒DNA,证实了PML诊断.
- 在诊断时,该疾病已经进展显著,导致致命的结局.
结论:
- 在患有光盘性狼的患者中,即使没有常见的危险因素,PML也可能发生.
- 保持高临床怀疑指数对于在患有自身免疫性疾病的患者中早期诊断PML至关重要.
- 这一案例凸显了在 discoid lupus 患者的神经缺陷的差异诊断中考虑 PML 的必要性.
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