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临床沉默的粉样蛋白相关的成像异常与水在莱卡尼马布治疗后:一个病例报告

Imran Bitar¹, Mukhlis Alabdalrazzak², Mazen Zamzam¹

¹School of Medicine, Oakland University William Beaumont School of Medicine, Rochester, USA.

|September 30, 2025

概括

与 (ARIA-E) 相关的粉样蛋白成像异常可能发生在lecanemab治疗中. 这一案例表明,保守的管理可能适用于通过常规MRI监测检测到的无症状ARIA-E.

科学领域:

神经学神经学
放射学放射学是一门学科.
药理学药理学是指药理学的学科.

背景情况:

与相关的粉样蛋白成像异常 (ARIA-E) 是抗粉样蛋白单克隆抗体治疗的已知的并发症,包括lecanemab.
由于血管粉样蛋白被破坏,ARIA-E表现为血管性脑,在MRI上可以观察到T2 FLAIR超强度.
ARIA-E的临床表现从无症状发现到症状事件各不相同,需要在治疗期间保持警监测.

研究的目的:

在接受莱卡尼马布治疗阿尔茨海默病的患者中报告ARIA-E病例.
为了说明ARIA-E的成像发现和临床过程.
讨论在无症状ARIA-E病例中进行保守管理的可能性.

主要方法:

一个60岁妇女的案例研究,生物标志物证实了阿尔茨海默病 (AD).
这位患者每两周输注六次lecanemab.
对ARIA-E进行监视MRI进行了监视.

主要成果:

患者在和叶中出现了放射性明显的ARIA-E和新的T2 FLAIR超强度.
该ARIA-E与帕伦基马和沟胀一致.
在整个事件中,患者在神经学上保持无症状.

结论:

常规成像对于在抗粉样蛋白治疗期间检测ARIA-E至关重要.
保守的管理,包括停止lecanemab和密切跟踪,可以适合选择无症状ARIA-E病例.
这一案例强调了个性化治疗方法在管理ARIA-E.的重要性.

关键词:

这是阿尔茨海默氏症.与粉样蛋白相关的成像异常皮层水皮层水莱卡内马布 (lecanemab) 是一个单克隆抗体疗法单克隆抗体疗法

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