首次精神病发作中的自身免疫脑炎:在三级精神病中心进行前性非干预纵向研究
Vera Fominykh1, Irina Kovaleva2, Ekaterina Aksenova2
1Mental Health Clinic No. 4 Named After P.B. Gannushkin, Moscow, Russia.
Journal of neuroimmunology
|November 27, 2025
概括
自身免疫性脑炎 (AE) 影响3.5%的第一发精神病患者. 使用抗体检测和特定的临床症状进行早期诊断对于这些自身免疫性中枢神经系统疾病的有效治疗和改善结果至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 精神病学是一个精神病学.
背景情况:
- 自身免疫性脑炎 (AE) 是一组免疫媒介的中枢神经系统疾病.
- AE可以表现为精神症状,使第一发精神病 (FEP) 患者的诊断复杂化.
- 目前用于AE和自身免疫精神病 (AP) 的诊断算法需要在FEP队列中进行评估.
研究的目的:
- 在第三级精神病医院的FEP患者中前性地识别和描述AE.
- 评估FEP中AE和AP现有的诊断算法的有效性.
- 评估免疫抑制治疗对AE患者结果的影响.
主要方法:
- 连续评估FEP患者的纳入/排除标准.
- 临床评估,血清和脑脊液 (CSF) 分析,包括抗体测试 (神经,NMDA,CASPR2,LGi1,GABAb,AMPA1,2,GAD,ANA,dsDNA,甲状腺).
- 应用格劳斯标准来诊断AE,然后进行免疫抑制治疗和9-12个月的随访.
主要成果:
- 包括143名FEP患者;3.5% (5名患者) 被诊断为AE.
- 确诊的AE病例包括各种抗体概况 (抗AMPH,抗AMPA2,抗GABAb,抗yo,CSF阳性).
- 结果各不相同:1例死亡,3例恢复工作的良好结果.
结论:
- 在这个东欧FEP队列中,AE患病率为3.5%.
- 存在诊断方面的挑战,其中一个病例缺乏临床"红旗",另一个仅在CSF中呈阳性.
- 结合AE标准",红旗",血清和CSF抗体测试对于改善FEP中的AE诊断至关重要.
相关概念视频
Autoimmune Disorders
1.4K
Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
Concept and Mechanism of Autoimmune Diseases
The immune...
1.4K
Psychosis: Goals of Pharmacotherapy
446
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
446
Psychosis and Antipsychotic Drugs: Overview
779
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
779
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
1.8K
Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
1.8K


