大人的登革热脑病变是由于1型登革热病毒感染引起的
Xingyu Leng1, Huiqin Yang1, Lingzhai Zhao2
1Guangzhou Medical Research Institute of Infectious Diseases, Department of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, 510000, Guangzhou, P.R. China.
BMC infectious diseases
|March 16, 2024
概括
1型登革热病毒 (DENV-1) 可以导致成年人中枢神经系统 (CNS) 损伤,呈现为脑病变. 早期使用激素和马球蛋白治疗可能有助于从DENV-1神经复杂症中恢复.
科学领域:
- 病毒学 病毒学
- 神经学 神经学
- 传染性疾病 传染性疾病
背景情况:
- 登革热病毒 (DENV) 感染对全球健康构成重大挑战,有四种不同的血清型.
- 中枢神经系统 (CNS) 损伤是一种严重的并发症,通常与DENV-2和DENV-3有关.
- 来自DENV-1的神经并发症并不常见,特别是在成年人群中.
研究的目的:
- 报告DENV-1引起的成年人脑病变的罕见病例.
- 调查DENV-1在病毒病期间直接侵入中枢神经系统的情况.
- 评估DENV-1引起的神经复杂症的特定治疗方法的疗效.
主要方法:
- 一个44岁的男性患者的案例研究,在病后8天被诊断出登革热.
- 在脑脊液 (CSF) 和血清中检测DENV-1RNA,并进行完整的病毒测序.
- 在关键阶段监测细胞因子水平 (IL-6,IL-10,sVCAM-1).
主要成果:
- 患者表现为昏迷,沉睡,肌肉强度下降,妄和易怒,尽管最初的X光和CSF检测结果正常.
- 在CSF和血清中都确认了DENV-1RNA,这表明中枢神经系统直接参与.
- 在严重疾病阶段观察到IL-6,IL-10和sVCAM-1的水平升高.
结论:
- 成人的脑病直接归因于DENV-1在活跃病毒病期间对中枢神经系统的入侵.
- 用低剂量激素和马环球蛋白治疗在治疗患者的病情方面显得有益.
- 这一案例凸显了DENV-1在成年人中引起严重神经疾病的潜力.
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