一个免疫能力强的年轻成年人的无菌性脑炎:一个病例报告
Abigail J Saldaña Solano1, Karina Carrillo Loza2, Juan Benítez Valenzuela2
1Cell Reprogramming Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
Cureus
|September 12, 2025
概括
诊断脑炎可能很困难,特别是当测试不确时. 这一案例突显了脑脊液 (CSF) 中的基克隆带 (OCB) 如何表明免疫激活,有助于无菌脑炎的诊断.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 诊断医学 诊断医学
背景情况:
- 脑炎带来了诊断上的挑战,特别是当怀疑有体干预,但没有发现具体原因时.
- 感染后的亚急性神经精神症状可能表明有未知的病因的脑炎.
研究的目的:
- 报告一个无菌性脑炎病例,初步发现不确.
- 讨论橄克隆带 (OCB) 和神经成像在脑炎中的诊断效用.
- 强调应用脑炎诊断标准的重要性,以避免误诊.
主要方法:
- 一个27岁的男性患有亚急性神经精神病症状的病例报告.
- 临床表现分析,神经成像 (磁共振成像) 和脑脊液 (CSF) 分析,包括OCB检测.
- 对自身免疫性脑炎的2016年格劳斯诊断标准的应用.
主要成果:
- 神经成像显示了前干涉.
- 脑脊液分析检测到OCBs,表明非特异性免疫激活.
- 麻醉性脑炎的诊断是基于单相疗程,阴性抗体测试和临床稳定性,排除了可能的阴性血清性自身免疫脑炎.
结论:
- 脑液中的OCB是脑炎中免疫激活的非特异性标记物.
- 2016年格劳斯标准对于排除血清阴性自身免疫脑炎有价值.
- 脑炎的准确诊断需要整合临床背景,免疫学发现和既定标准,以指导治疗并防止不必要的免疫抑制.
相关概念视频
Development of Immunocompetence
795
The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
795
Acute Pyelonephritis I: Introduction
508
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
508
Acute Pyelonephritis II: Diagnostic Studies and Management
323
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
323
Endocarditis II: Clinical Features of Infective Endocarditis
427
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
427
Acute Pharyngitis
3.9K
Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
3.9K
Endocarditis I: Introduction
398
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
398


