多发性硬化症患者接受ocrelizumab治疗的肠道病毒脑炎:来自多中心病例系列的见解
Samantha A Banks1,2, Ilia Poliakov3, Eoin P Flanagan1,2,4
1Department of Neurology, Mayo Clinic, Rochester, MN.
Neurology(R) neuroimmunology & neuroinflammation
|December 23, 2025
概括
治疗多发性硬化症 (MS) 的ocrelizumab很少会导致肠道病毒脑炎. 低型球蛋白血症可能会增加风险,突出显示临床医生的意识和MS患者及时诊断的需要.
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:
- 抗CD20疗法,如ocrelizumab,对于多发性硬化症 (MS) 是有效的.
- 识别和管理与这些疗法相关的传染性并发症对于患者安全至关重要.
- 肠道病毒脑炎是一种潜在的,尽管罕见的并发症.
研究的目的:
- 为了识别和描述与ocrelizumab治疗的MS (pwMS) 患者的肠道病毒脑炎病例.
- 了解这种并发症的临床表现,诊断结果和结果.
主要方法:
- 来自三个多发性硬化中心的非识别临床数据的回顾性审查.
- 纳入标准:接受ocrelizumab的pwMS患有肠道病毒脑炎.
- 收集的数据包括人口统计,MS特征,ocrelizumab暴露,临床表现,MRI发现,CSF分析和结果.
主要成果:
- 在接受ocrelizumab治疗的5名pwMS患者被发现患有肠道病毒脑炎.
- 平均年龄为34岁,中位数MS持续时间为5年,中位数ocrelizumab暴露时间为3年.
- 常见的发现包括中枢神经液多细胞化,中枢神经液/血液中肠道病毒检测,以及四分之四的测试患者的低血糖球蛋白血症. 其余症状很常见 (4/5的患者).
结论:
- 肠道病毒脑炎是使用ocrelizumab治疗的pwMS的一个罕见但严重的并发症.
- 低型环球蛋白血症可能是相关的危险因素.
- 提高临床医生的意识和及时的诊断测试对于改善患者的治疗结果至关重要.
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