患有血清阴性自身免疫脑炎的儿童的临床特征和结果
Jihan Madani1, Carmen Yea2, Areej Mahjoub1
1Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Developmental medicine and child neurology
|March 16, 2024
概括
没有抗体的儿童自身免疫脑炎往往导致持久的神经缺陷. 自体免疫脑炎的临床评估量表 (CASE) 或其儿科版本 (ped-CASE) 比修改的兰金量表 (mRS) 更好地预测糟糕的结果.
科学领域:
- 儿科神经学 儿科神经学
- 自身免疫性疾病 自身免疫性疾病
- 神经免疫学 神经免疫学
背景情况:
- 血清阴性自身免疫脑炎缺乏特异性抗体,这给儿童带来了诊断和预后挑战.
- 了解呈现特征和结果对于有效管理儿科自身免疫脑炎至关重要.
研究的目的:
- 描述被诊断患有血清阴性自身免疫脑炎的儿童的临床表现和结果.
- 评估修改后兰金度表 (mRS) 和自身免疫脑炎 (CASE) /儿科CASE (ped-CASE) 临床评估度表在患者结局的最低点上的预测值.
主要方法:
- 一项涉及18岁以下患有血清阴性自身免疫脑炎的儿童的观察性研究.
- 收集人口统计和临床数据,包括神经症状.
- 使用mRS和CASE/ped-CASE评分进行严重性评估;使用描述性统计和后勤回归进行分析.
主要成果:
- 包括63名儿童 (62%为女性,平均年龄为7岁);56人有随访数据 (中位数为12.2个月).
- 脑病是最常见的呈现症状 (81%).
- 在59%的患者中观察到持续的神经缺陷;CASE/ped-CASE得分比mRS得分更容易预测更糟糕的结果.
结论:
- 患有血清阴性自身免疫脑炎的儿童经常经历持续的神经缺陷.
- 与mRS相比,CASE/ped-CASE尺度表现出优越的能力,能够识别出具有较差结果的儿童.
- 使用CASE/ped-CASE早期识别潜在的不良结果可以为儿童自身免疫脑炎的治疗策略和预后提供信息.
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