丹麦的疹后抗NMDAR脑炎:目前的状况和未来的挑战
Anna Søgaard1, Charlotte Aaberg Poulsen2, Nadia Zeeberg Belhouche1
1Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark.
Biomedicines
|September 28, 2024
概括
在丹麦,简单疹病毒1型脑炎 (HSE) 后的N-甲基-D-酸盐受体脑炎 (NMDARE) 的发生率很低,成人病例可能被诊断不足. 儿童病例明显缺席,引发了人们的担忧.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 简单疹病毒1型脑炎 (HSE) 是已知的N-甲基-D-酸盐受体脑炎 (NMDARE) 的触发因素.
- 丹麦的HSE后NMDARE的发病率和诊断模式在很大程度上是未知的.
- 了解这种关联对于改善诊断和患者结果至关重要.
研究的目的:
- 为了确定丹麦HSE后NMDARE的发病率.
- 将丹麦HSE后NMDARE患者的临床特征与现有文献进行比较.
- 评估丹麦HSE患者中NMDARE的诊断率.
主要方法:
- 全球80个HSE后NMDARE病例的文献综述.
- 丹麦国家自身免疫脑炎和区域传染性脑炎数据库 (2009-2021) 的回顾性分析.
- 在文献和丹麦队列之间比较临床表型和诊断标准 (Graus标准).
主要成果:
- 在丹麦发现了9名HSE后NMDARE患者;没有儿童.
- 文献中的病例主要影响儿童 (66%),有明显的症状.
- 在丹麦,36%的HSE患者符合NMDARE标准,但只有17%的可用CSF患者对NMDARE抗体呈阳性;整体诊断率低 (在一个地区为7%).
结论:
- 成人后HSE NMDARE在丹麦似乎被诊断不足,在一个地区的低发病率为0.17每百万/年.
- 丹麦缺乏确定的儿科后HSE NMDARE病例令人担忧,需要进一步调查.
- 需要在HSE患者中改进NMDARE的诊断策略.
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