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作为多发性硬化症初始表现的耐火性打和麻木病例
1Internal Medicine and Pediatrics, Kohokuekimae Ohisama Clinic, Tokyo, JPN.
Cureus
|May 7, 2025
概括
吸收性打可能是多发性硬化症 (MS) 的罕见初始症状,这是一个中枢神经系统的自身免疫性疾病. 认识到这种非典型的表现有助于MS的早期诊断和治疗.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 神经免疫学 神经免疫学
背景情况:
- 多发性硬化症 (MS) 是中枢神经系统 (CNS) 的一种慢性自身免疫性脱髓化疾病.
- 典型的初始症状包括视神经炎,运动或感官障碍.
- 作为MS的初始表现,吸收性打是非常罕见的.
研究的目的:
- 突出认识到难以治愈的打是MS的一个非典型的症状的重要性.
- 讨论基克隆带阴性MS的诊断挑战.
- 探索可能用于MS诊断的替代生物标志物.
主要方法:
- 一个19岁的女性患有难以治愈的打和神经缺陷的案例报告.
- 临床检查,大脑和椎脊柱MRI (T2加权和对比度增强的T1加权成像).
- 对AQP4-IgG和MOG-IgG进行血清检测,根据2017年麦当劳标准进行诊断.
主要成果:
- 患者出现了难以治愈的打,右臂和干部逐渐麻木,虚弱,感官受损和反射过度.
- 核磁共振扫描显示,脊髓和椎脊柱 (C2-C6) 中枢神经系统的病变.
- 尽管AQP4-IgG和MOG-IgG呈阴性,但MS的诊断得到证实,并且没有提到橄克隆带.
结论:
- 吸收性打可能是MS的脑干症状,需要在差异诊断中考虑.
- 早期诊断和管理,包括B细胞枯竭疗法,可以改善结果.
- 神经纤维光链 (NfL) 在具有挑战性的MS病例中可以作为替代生物标志物.
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