怀疑自身免疫性脑炎:对患者进行了回顾性研究,这些患者被转诊治疗性血交换
Elizabeth P Crowe1, Luisa A Diaz-Arias2, Ralph Habis2
1Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of clinical apheresis
|April 18, 2024
概括
对于疑似自身免疫性脑炎 (AE) 的治疗性血交换 (TPE) 通常是安全的,尽管它的有效性在没有对照试验的情况下尚不清楚,特别是在血清阴性病例中. 需要进一步的研究来确认TPE.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 自身免疫性脑炎 (AE) 涵盖了各种自身抗体介导的大脑疾病.
- 治疗性血交换 (TPE) 是一线AE疗法,通常是经验性启动的.
- 在疑似AE中TPE的作用需要进一步描述.
研究的目的:
- 描述TPE在疑似AE患者中的作用和结果.
- 评估TPE在这个患者群体中的安全性和有效性.
主要方法:
- 对37名因疑似AE而接受TPE的成年患者的回顾性分析.
- 收集的数据包括人口统计,治疗过程,不良事件和结果 (修改的兰金级).
- 最终的诊断在调查后得到证实.
主要成果:
- 43.2%的患者在自身免疫抗体测试中呈阳性.
- 患者接受了平均5次TPE手术,40.5%的患者经历了不良事件.
- 结果各不相同:21.6%改善,59.5%没有变化,18.9%根据mRS.恶化.
- 确定的AE诊断在48.6%的患者中得到证实;16.2%的患者有不同的病因.
结论:
- 对于疑似AE的实证TPE通常是耐受良好.
- 对于TPE的有效性仍然不确定,特别是在血清阴性AE中,等待对照试验.
- 进一步的研究是有必要的,以建立最终的治疗指南.
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