自免疫性脑炎和SSPE之间的诊断困境:两名儿科患者的病例报告
Shikha Jain1, Arya James2, Sai Vamshi Varanasi2
1Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India. Shikha.5dec@gmail.com.
Indian journal of pediatrics
|May 30, 2025
概括
亚急性硬化大脑炎 (SSPE) 和自身免疫性脑炎 (AE) 可以出现重叠的症状. 区分这些疾病,特别是当存在抗麻疹和NMDAR抗体时,对于准确的诊断和治疗至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 亚急性硬化大脑炎 (SSPE) 是一种罕见的,在麻疹感染后进展的神经系统疾病.
- 自身免疫性脑炎 (AE) 是一种具有各种神经和精神症状的中枢神经系统炎症性疾病.
- 儿科AE经常出现和运动障碍,使其与典型的SSPE呈现不同.
研究的目的:
- 要突出诊断挑战在区分SSPE和AE在儿科病例.
- 强调识别重叠的临床特征和血清学标志物的重要性.
- 为了强调由于不同的管理策略和预测,需要准确的诊断.
主要方法:
- 两名儿科患者的病例报告呈现了SSPE和AE的差异诊断.
- 对临床表现,神经学检查和脑脊液 (CSF) 发现的分析.
- 在CSF中同时检测抗麻疹抗体和N-甲基-D-酸盐受体 (NMDAR) 抗体.
主要成果:
- 这两种病例都表现出重叠的临床症状,表明SSPE和AE.
- 这两名患者的脑脊髓液中抗麻疹抗体和NMDAR抗体均呈阳性.
- 双抗体阳性的存在使诊断过程复杂化.
结论:
- 区分SSPE与AE至关重要,因为治疗方法和结果截然不同.
- 在CSF中同时检测抗麻疹和NMDAR抗体存在诊断困境.
- 对这些重叠条件的病理生理学和诊断标记进行进一步的研究是有必要的,以防止误诊.
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