儿科自身免疫脑炎的预后因素和治疗结果:一个多中心研究
Ahlam Ahmed Abu Melha1,2,3,4, Amjad Saad Aldress1,2,3,4, Fahad Alamri5
1Department of Pediatric Neurology, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Frontiers in neurology
|September 17, 2024
概括
联合免疫疗法显著改善了儿科自身免疫脑炎 (AE) 患者的长期结果,降低了残疾分数. 早期干预是关键,尽管一些残留的神经效应可能会持续存在.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 儿科 儿科 儿科
背景情况:
- 自身免疫性脑炎 (AE) 是一种具有多种症状的急性神经疾病,通常是由感染或瘤引发的.
- 改进的诊断方法增加了AE检测,但近40%的患者对初始治疗没有反应.
- 了解自身抗体,免疫细胞和细胞因子的相互作用对于开发有效疗法至关重要.
研究的目的:
- 分析儿科AE患者的临床特征,自身抗体患病率和治疗结果.
- 确定与儿科AE的不良结果相关的预后因素.
- 评估各种免疫疗法在治疗儿科AE的有效性.
主要方法:
- 在两个三级保健中心进行了一项回顾性观察性研究.
- 收集的数据包括临床表现,自身抗体结果,治疗策略和在呈现和随访时的残疾分数.
- 预测不良结果的预后因素被划定.
主要成果:
- 神经精神症状,脑病和是最常见的表现.
- 年龄较小,耐性发作和严重脑病与较高的残疾分数相关.
- 接受联合免疫治疗的患者在长期随访期间,残疾分数从严重到轻度显著改善.
结论:
- 在耐药儿科AE病例中,早期联合免疫疗法可显著改善长期残疾得分.
- 多面性免疫疗法在治疗儿科耐火性AE方面发挥着至关重要的作用.
- 尽管治疗有好处,但对认知,行为和语言的残留影响可能会持续存在.
相关概念视频
Encephalitis l: Introduction
15
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...
15
Encephalitis ll: Pathophysiology
22
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
22


