一个患有复发性多发性硬化症 (MS) 患者的严重的传染性脑炎 (TBE) 过程,该患者接受了ocrelizumab治疗
Jonathan A Gernert1, Matthias Klein2, Florian Schöberl2
1Institute of Clinical Neuroimmunology, LMU University Hospital, LMU Munich, Munich, Germany; Department of Neurology with Friedrich Baur Institute, LMU University Hospital, LMU Munich, Munich, Germany.
概括
一名患有多发性硬化症 (MS) 的患者接受了ocrelizumab免疫疗法,患有严重的传播脑炎 (TBE). 由于B细胞枯竭影响了血清学,导致诊断延迟,突出显示了对先进分子诊断的需要.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 多发性硬化症 (MS) 是一种自身免疫性疾病,可以通过免疫疗法治疗.
- 奥克雷利祖马布是一种用于MS治疗的B细胞耗尽疗法.
- 引起的脑炎 (TBE) 是一种严重的神经感染.
研究的目的:
- 描述一个MS患者用ocrelizumab治疗的严重TBE病例.
- 为了突出免疫受损患者的诊断挑战.
- 强调高级分子技术在TBE诊断中的有用性.
主要方法:
- 一个33岁的男性患者的病例报告.
- 临床表现:急性小脑炎与桃体.
- 诊断确认:聚合酶连锁反应 (PCR) 和大脑脊髓液的基因组下一代测序 (mNGS) 和大脑活检.
主要成果:
- 患者经历了严重的TBE过程.
- 由于由ocrelizumab诱导的B细胞枯竭,TBE的初始血清检测呈阴性.
- 通过PCR和mNGS成功识别了TBE病毒 (TBEV),并获得了近乎完整的基因组.
结论:
- 治疗ocrelizumab可以通过干扰血清学测试来复杂化TBE诊断.
- 基因组测序为诊断免疫受损患者的TBE提供了一个有价值的工具.
- 早期和准确的诊断对于管理严重的TBE病例至关重要,即使有诊断挑战.
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