在患有性结肠炎的年轻女性中,由肠炎复杂的初级CMV感染的类固醇反应性脑病变
Ryosuke Oka1, Hajime Yoshimura1, Shigeo Hara2
1Department of Neurology, Kobe City Medical Center General Hospital, Japan.
Internal medicine (Tokyo, Japan)
|May 28, 2025
概括
一次性细胞巨乳病毒 (CMV) 感染可以导致性结肠炎 (UC) 患者的类固醇反应性脑病变. 同时发生的CMV肠炎也需要考虑和特殊治疗.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
背景情况:
- 性结肠炎 (UC) 是一种慢性炎症性肠病.
- 细胞巨乳病毒 (CMV) 感染可以发生在免疫功能低下的人群中,包括患有UC的人群.
- 在UC患者的神经并发症并不罕见,但作为脑病变的原因的初级CMV感染是罕见的.
研究的目的:
- 报告一个UC患者出现脑病变和肠炎的病例,原因是初级CMV感染.
- 要突出诊断挑战和治疗影响的UC同时发生的CMV感染.
- 强调在UC患者中考虑CMV的重要性,这些患者有神经症状和胃肠道出血.
主要方法:
- 一个23岁的女性患有UC的病例报告.
- 神经学检查,MRI和EEG用于脑病变的评估.
- 血清学分析,脑液分析 (包括白内素-6水平) 和结肠活检用于CMV检测和肠炎诊断.
主要成果:
- 患者出现了发烧,头痛,精神状态变化和血.
- 神经学发现表明右侧主导脑病变.
- 发现中枢神经液中白血素-6水平升高,但中枢神经液中没有病毒载荷;血清学证实了初级CMV感染.
- 脑病变通过使用类固醇改善,而CMV肠炎则用甘西克洛维尔成功治疗.
结论:
- 类固醇反应性脑病变可能是初级CMV感染的表现.
- 在初级CMV感染期间出现胃肠道出血的UC患者中应考虑CMV肠炎.
- 及时诊断和向治疗对于管理UC患者的CMV并发症至关重要.
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