MOG脑炎是儿童中最常见的自身免疫脑炎:MERIN脑炎研究数据
Ruth Helena Fellmeth1, Lampros Kousoulos1, George Christoph Korenke2
1Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Datteln, Germany.
Neuropediatrics
|April 10, 2025
概括
自体免疫脑炎 (AE) 在儿童中很罕见,与髓寡干细胞糖蛋白抗体相关疾病 (MOGAD) 和可能的抗体阴性AE不经常发生. 建议对MOG抗体进行测试,以诊断儿科脑炎.
科学领域:
- 儿科神经学 儿科神经学
- 神经免疫学 神经免疫学
- 传染性疾病 传染性疾病
背景情况:
- 儿童脑炎可能源于感染或自身免疫过程.
- 儿童群体中自身免疫性脑炎 (AE) 的患病率尚不清楚.
- 髓寡细胞糖蛋白抗体相关疾病 (MOGAD) 是一种显著的自身免疫神经系统疾病.
研究的目的:
- 为了确定MOG抗体介导的儿童自身免疫脑炎 (AE) 的频率.
- 为了调查抗N-甲基-D-酸盐受体 (NMDAR) 抗体在儿科脑炎中的发生.
- 评估儿童AE的诊断标准.
主要方法:
- 在2011-2020年间,从下萨克森州脑膜炎/脑炎登记册 (MERIN) 中回顾了1341名儿童的病历.
- 包括可能患有AE的儿童,病原体相关脑炎 (对照组) 和可用的血清样本.
- 使用基于细胞和组织的测试 (TBA) 检测血清样本的MOG和NMDAR抗体.
主要成果:
- 在55名被纳入儿童中,有39人符合可能的AE标准;16人患有病原体相关的脑膜炎.
- 在39名可能患有AE的儿童中,有3人被诊断出患有MOG抗体相关疾病 (MOGAD).
- 没有检测到NMDAR抗体;39名患者中有5名符合可能抗体阴性AE的标准.
结论:
- 抗体介导的AE和可能的抗体阴性AE在儿童中很罕见.
- 目前对AE的诊断标准是合适的,但应纳入MOG抗体测试.
- 未发现的抗体可能会在儿科病例中导致AE.
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