巴西自身免疫脑炎网络 (BrAIN):来自多中心研究的抗体概况和临床特征
Bruna de Freitas Dias1, Fabio Fieni Toso1, Maria Eduarda Slhessarenko Fraife Barreto1
1Hospital Israelita Albert Einstein, São Paulo, Brazil.
Frontiers in immunology
|November 13, 2023
概括
巴西的自身免疫性脑炎 (AIE) 显示,抗NMDAR是最常见的抗体. 诊断延迟仍然存在,突出了发展中国家的挑战,并为预测阳性艾滋病病毒的预测提供了见解.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 自身免疫性脑炎 (AIE) 抗体的患病率在全球范围内有所不同,发展中国家的数据有限.
- 了解巴西AIE的临床特征对于改善诊断和治疗至关重要.
研究的目的:
- 描述巴西AIE的临床表现.
- 调查季节性并确定成人和儿科患者AIE的预测因子.
主要方法:
- 在巴西 (2018-2022) 参与564名可能患有AIE的患者的多中心研究.
- 用于抗体检测 (TBA和CBA) 的血清和CSF分析.
- 临床数据,调查和治疗的汇编;季节性和预测因素的统计分析.
主要成果:
- 145名患者 (25.7%) 对AIE抗体呈血清阳性;69人 (12.23%) 呈血清阴性.
- 抗NMDAR抗体最常见 (54%),其次是抗MOG (9%) 和抗LGI1 (8%).
- 诊断延迟的中位数为5.97个月;没有观察到季节性. 儿科预测因素包括意识下降和胆固醇;成人预测因素包括运动障碍,,自主不稳定和记忆障碍.
结论:
- 抗NMDAR,抗MOG和抗LGI1是巴西AIE患者中最常见的抗体.
- 显著的诊断延迟和抗体检测方面的挑战 (26%的血清阳性,12%的血清阴性) 强调了发展中国家的障碍.
- 临床表现如意识下降,胆固醇,运动障碍和记忆障碍可以预测血清阳性AIE,帮助早期诊断.
相关概念视频
Arboviral Encephalitis
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...


