双边视神经炎在Baló集中性硬化病变之前:一个病例报告和文献综述
David F Alfonso-Cedeño1, Lorena Medina-Lozano1, Paula V Gaete1
1Faculty of Medicine, Universidad Nacional de Colombia, Colombia.
Journal of neuroimmunology
|January 31, 2026
概括
巴洛集中性硬化症 (BCS) 是一种罕见的脱髓化疾病,由于症状与其他神经疾病重叠,因此存在诊断挑战. 这一案例凸显了综合成像和免疫学发现对于准确的BCS诊断和管理的重要性.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 放射学 放射学是一门学科.
背景情况:
- 巴洛集中性硬化症 (BCS) 是一种罕见的炎症性脱髓化疾病.
- BCS的特点是同心的非髓化和髓化纤维层,在MRI上形成"洋灯泡"模式.
- 它的稀有性和与多发性硬化症和神经髓炎光谱障碍 (NMOSD) 重叠的特征使诊断复杂化.
研究的目的:
- 报告一个具有挑战性的Baló集中性硬化症 (BCS) 病例在一个60岁的男性中.
- 为了说明诊断的复杂性和整合成像和免疫学发现在BCS中的重要性.
- 讨论B细胞消耗疗法在管理BCS复发中的潜在作用.
主要方法:
- 一个60岁的男性患有急性视力丧失和随后的神经缺陷的病例报告.
- 利用了大脑和椎的磁共振成像 (MRI).
- 对脑脊液 (CSF) 进行分析,以检测橄克隆带,抗体 (抗aquaporin 4,抗髓 oligodendrocyte glycoprotein),蛋白质和葡萄糖水平.
- 记录了对治疗的反应,包括静脉注射甲基普雷迪尼索隆,等离子体酶和利图西马布治疗.
主要成果:
- 最初的表现包括双边视力丧失,正常的大脑MRI和椎脊髓损伤.
- 诊断最初是具有挑战性的,被认为是血清阴性NMOSD.
- 复发呈现出凸骨症状和特征的集中性病变在脑MRI上.
- 血酶消除了圆柱状症状;利图西马布实现了临床稳定性,表明它在预防复发方面具有潜在的有效性.
结论:
- 这一案例凸显了Baló集中性硬化症 (BCS) 的诊断困难.
- 综合的神经成像和免疫学评估对于准确的BCS诊断至关重要.
- B细胞消耗疗法,如rituximab,在管理BCS和预防疾病复发方面表现有前途.
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