布罗利祖马布诱导的自身免疫脑炎:一个罕见的病例
Dalal A Obaid1, Noora Jatan2, Khawla Y Alawadhi3
1Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Cureus
|February 24, 2026
概括
免疫检查点抑制剂诱导脑炎 (ICIiE) 是癌症免疫疗法的罕见副作用. 及时诊断和使用类固醇治疗可以导致患有这种神经复杂症的患者完全神经恢复.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI),如 pembrolizumab,是有效的癌症疗法.
- ICI诱导脑炎 (ICIiE) 是一种罕见但严重的神经系统不良事件.
- ICIiE的症状可以模仿其他疾病,使诊断复杂化.
研究的目的:
- 在接受 pembrolizumab 治疗的患者中报告 ICIiE 的病例.
- 强调诊断的挑战和早期识别的重要性.
- 为了突出及时免疫抑制治疗的有效性.
主要方法:
- 一个63岁的患有乳腺癌的妇女接受pembrolizumab的病例报告.
- 临床表现,诊断工作,包括CSF分析和MRI.
- 用高剂量静脉注射甲基prednisolone进行治疗.
主要成果:
- 患者发烧,神经认知能力逐渐下降.
- 感染性工作是负面的;CSF显示了淋巴细胞多细胞化.
- 用甲基prednisolone治疗导致神经快速恢复.
结论:
- 在接受免疫疗法且有不明原因的神经症状的患者中,应该怀疑ICIiE.
- 早期诊断和治疗对于有利的结果至关重要.
- 多学科评估和及时免疫抑制是关键.
相关概念视频
Arboviral Encephalitis
59
Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
59
Encephalitis l: Introduction
15
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
15
Encephalitis ll: Pathophysiology
22
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
22
Brain Abscess l: Introduction
21
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
21


