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在诱导化疗期间患有急性淋巴细胞白血病的3名青少年患者的急性脑病:一系列病例

Vivien W Y Li¹, Annie T G Chiu², Grace K S Lam³

¹Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital and Duchess of Kent Children's Hospital.

Journal of pediatric hematology/oncology

|June 25, 2025

概括

青少年白血病患者在化疗期间出现了模仿抗NMDAR脑炎的神经症状. 营养不良和肝脏问题的生化变化,而不是抗体,可能参与其中,这表明常见的途径和需要营养支持.

科学领域:

神经科学是一个神经科学.
在瘤学瘤学.
生物化学生物化学

背景情况:

B细胞急性淋巴细胞白血病 (B-ALL) 是一种常见的儿童癌症.
在癌症治疗期间可以出现神经精神症状.
抗N-甲基-D-酸盐受体 (anti-NMDAR) 脑炎呈现出严重的神经和精神症状.

研究的目的:

在接受化疗的青少年B-ALL患者中调查神经和精神症状的原因.
探索化疗诱导的代谢变化与NMDA受体功能障碍之间的潜在联系.
为了区分这些症状与实际的抗NMDAR脑炎.

主要方法:

三名患有B-ALL.的青少年患者的案例研究.
在诱导化疗期间对神经和精神症状的临床观察.
实验室分析包括NMDAR抗体测试,血液氨,血酸和铜水平.
评估肝功能和营养状况.

主要成果:

这三名患者都呈现出类似于抗NMDAR脑炎的症状,包括精神病,沉默,运动障碍和昼夜节律障碍.
在所有患者中,NMDAR抗体测试呈阴性.
患者表现出化疗诱导的肝功能障碍,体重减轻和营养不良.
观察到生物化学异常,如血氨含量升高,血中谷氨酸含量升高和铜缺乏.
已知这些生化变化会影响NMDA受体活性.

结论:

这些B-ALL患者的神经和精神症状不是由抗NMDAR抗体引起的.
化疗诱导的代谢障碍,包括影响NMDA受体功能的代谢障碍,可能导致观察到的神经毒性.
在B-ALL神经毒性和抗NMDAR脑炎之间可能有共同的,但尚未定义的病理生理路径.
早期的营养干预对于那些有这种神经毒性发展风险的B-ALL患者至关重要.

关键词:

抗NMDAR脑炎的治疗方法铜铜铜铜的铜.脑病变 - - 脑病变是一种脑病变.谷氨酸酸盐的使用方法这种白血病是白血病.胺胺的使用方法

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