一个患有反复头痛,发烧和扩散脑膜增强的孩子在MRI上
Pratiksha Khatua1, Jigna Bathia2, Hriday De2
1Institute of Child Health, Kolkata, 700017, West Bengal, India. pratiksha.khatua@gmail.com.
Clinical rheumatology
|August 10, 2024
概括
青少年神经狼 (NPSLE) 最初可能出现神经症状. 将NPSLE与其他疾病区分开来,需要进行全面的临床,生化和成像分析.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 神经免疫学 神经免疫学
- 系统性红斑性狼 红斑性狼 系统性狼
背景情况:
- 青春期开始的全身性红斑狼 (SLE) 经常涉及中枢神经系统,称为神经性SLE (NPSLE).
- 神经精神疾病的表现往往是儿科NPSLE的最初临床表现.
- 病原发生涉及微血管病变,血栓形成,自身抗体和炎症媒介.
研究的目的:
- 为了突出青少年神经狼出现神经精神病症状的诊断挑战.
- 强调NPSLE多学科诊断方法的重要性.
主要方法:
- 病例报告详细介绍了一名患者最初的偏头痛类似的头痛,进展到发烧和偏头痛.
- 包括调查:自抗体测量 (ANA,dSDNA),脑脊液 (CSF) 分析,炎症标志物 (ESR,CRP) 和脑部MRI.
- 临床发现,实验室结果和神经成像用于诊断的相关性.
主要成果:
- 患者呈现出慢性头痛,发烧,帕帕雷西斯和视网膜出血.
- 实验室发现包括贫血,中性细胞白细胞症,血小板减少,ESR和CRP升高,以及高血球蛋白水平.
- 核磁共振扫描显示了扩散的脑膜增强,最初暗示脑膜炎,但CSF分析正常. 发现了阳性ANA和抗dsDNA抗体,C3和C4水平较低.
结论:
- 在儿科患者的MRI上,扩散性脑膜增强并不总是表明脑膜炎.
- 准确诊断NPSLE需要对临床表现,生化数据和神经成像发现进行验证.
- 早期和准确的诊断对于及时管理青少年神经狼至关重要.
关键词:
大脑静脉鼻血栓塞的发生.青少年神经狼群 (Juvenile Neurolupus) 是一种神经狼群.系统性红血性狼 (Systemic lupus erythematosusus) 是一种全身性狼.更多相关视频
09:35Isolating Central Nervous System Tissues and Associated Meninges for the Downstream Analysis of Immune cells
Published on: May 19, 2020
9.2K
09:57Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
2.6K
相关概念视频
Cranial and Spinal Meninges
4.5K
The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
4.5K
Viral Meningitis
217
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
217
Bacterial Meningitis I: Introduction
31
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
31
Bacterial Meningitis II: Pathophysiology
45
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
45
Encephalitis l: Introduction
27
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...
27
Brain Abscess l: Introduction
47
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
47
