抗体阳性自身免疫脑炎和神经瘤性神经综合征:一个瑞典病例系列
Sonja Kosek1,2, Joachim Burman1, Anna Rostedt Punga1
1Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Brain and behavior
|May 4, 2024
概括
瑞典患有自身免疫性脑炎 (AE) 和神经瘤神经综合征 (PNS) 的患者表现出与其他地区相似的特征,除了抗NMDAR脑炎,其发病时间较早. 非瘤相关的AE病例主要发生在温暖的季节.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 自身免疫性脑炎 (AE) 和性神经综合征 (PNS) 是一种免疫媒介的神经疾病.
- 了解它们的临床特征和疾病过程对于诊断和管理至关重要.
研究的目的:
- 探索瑞典AE和PNS患者的临床特征和时间性疾病过程.
- 根据抗体类型比较AE和PNS患者亚组.
主要方法:
- 在瑞典中部 (2015-2019) 37例抗体阳性AE和PNS病例的回顾性审查.
- 患者被分为几个小组:神经元表面抗体 (NSAbs),神经元上抗体和抗GAD65抗体.
主要成果:
- 抗LGI1和抗NMDAR是常见的NSAbs;抗NMDAR脑炎显示年龄分布较大 (中位数为40岁).
- 大多数患者有异常的CSF (90%) 和EEG (99%) 发现,但最初的MRI往往不显著 (30%).
- 与其他类型 (抗NMDAR,抗GABA-B) 相比,对某些抗体类型 (抗LGI1,抗CASPR2,抗IgLON5) 观察到延迟免疫疗法启动.
结论:
- 瑞典AE和PNS患者与国际队列相似,在抗NMDAR脑炎呈现方面有显著的例外.
- 非瘤相关的AE发作表现出季节性变化,主要在春季/夏季.
- 潜伏性AE发作与延迟免疫疗法启动相关.
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