中枢神经系统毒素菌素在自免疫性肝炎的单一治疗中
Sathish Krishnan1, Vijaya Sivalingam Ramalingam2, Anam Naumaan3
1Division of Pulmonary and Critical Care Medicine, Community Health Network, Indianapolis, IN, USA.
Journal of investigative medicine high impact case reports
|August 20, 2025
概括
中枢神经系统毒,一种罕见的机会性感染,发生在接受甲酸单一治疗的免疫受损患者中. 这一案例突显了非艾滋病毒,非移植患者的免疫抑制风险.
科学领域:
- 神经学
- 传染性疾病
- 免疫学
背景情况:
- 中枢神经系统 (中枢神经系统) 毒症通常发生在免疫受损的个体中,如艾滋病毒/艾滋病患者或器官移植患者.
- 它在免疫能力强的患者或单剂免疫抑制剂患者中很少发生.
- 接受免疫抑制剂的自身免疫性肝炎患者可能面临机会性感染的风险.
研究的目的:
- 报告中枢神经系统毒症的单一病例,该病例发生在接受菌酸单一治疗的自身免疫性肝炎患者中.
- 突出MMF单一治疗在非艾滋病毒,非移植人群中引起足够的免疫抑制.
- 提高临床医生的自我免疫疾病管理中神经感染的非典型表现的认识.
主要方法:
- 一个68岁的女性患有自身免疫性肝炎的病例报告.
- 临床表现:混乱和表达性失语.
- 诊断工作:脑部MRI显示环增强病变,立体活检证实*Toxoplasma gondii*和血清*Toxoplasma* IgG的升高.
主要成果:
- 患者出现了神经系统病变的症状.
- 大脑活检证实中枢神经系统毒素形成 (重新激活).
- 用硫甲- 三甲治疗导致临床和放射性改善,并停止使用MMF.
结论:
- 慢性MMF单一治疗可以足够削弱免疫防御,导致机会性感染,如中枢神经系统毒,即使在非艾滋病毒,非移植患者.
- 这一案例强调了MMF患者自身免疫性疾病的机会性感染风险被低估.
- 临床医生应考虑MMF患者的非典型神经感染,特别是那些患有自身免疫性疾病的患者.
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