怀孕第一季度反复出现的抗NMDA受体脑炎,最初具有抗体阴性CSF
Julia R Jahansooz1, Alyssa M Kameoka1, Jineane Shibuya2
1John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Journal of neuroimmunology
|April 4, 2025
概括
怀孕期间的抗N-甲基-d-酸盐受体 (anti-NMDAR) 脑炎可能出现延迟诊断. 重复测试脑脊液 (CSF) 和血清对于准确的诊断和及时的治疗至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 产科 产科 产科 产科 产科
背景情况:
- 抗N-甲基-d-酸盐受体 (anti-NMDAR) 脑炎主要影响生殖年龄的女性.
- 怀孕是抗NMDAR脑炎发病的罕见但已报告的时期.
- 早期诊断可能是具有挑战性的,因为最初的抗体测试是负的.
研究的目的:
- 在怀孕期间报告抗NMDAR脑炎病例.
- 突出诊断挑战和重复检测的重要性.
- 为了强调在孕妇患者中成功的治疗结果.
主要方法:
- 一个25岁的孕妇 (11周怀孕) 的病例报告,怀疑患有抗NMDAR脑炎.
- 最初的脑脊液 (CSF) 抗体测试是负的.
- 重复的血清和CSF抗体测试证实了诊断.
主要成果:
- 患者经历了间歇性混乱,最初的CSF抗体测试呈阴性.
- 延迟重复血清和脑脊液测试对NMDAR抗体呈阳性.
- 患者在治疗后恢复到基线,并分娩了一个健康的婴儿.
结论:
- 对抗NMDAR脑炎的脑脊液 (CSF) 抗体检测可能在疾病早期缺乏敏感性.
- 当临床怀疑仍然很高时,重复测试至关重要.
- 及时诊断和治疗可以为母亲和孩子带来良好的结果.
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