抗体阴性的自身免疫性脑炎1例临床分析
摘要
目的进一步了解抗体阴性的自身免疫性脑炎的临床特征及治疗转归。方法报道1例我院诊治的抗体阴性的自身免疫性脑炎患者的临床资料、影像学检查结果及治疗和预后。结果患者为中年男性,以精神行为异常亚急性起病。多次行脑脊液和血清自身免疫性脑炎抗体全套、副肿瘤综合征全套检测,均为阴性。发病3个月后颅脑MRI方出现病灶,表现双侧多发、大面积T2和FLAIR异常信号。病程较长,预后差。结论抗体阴性的自身免疫性脑炎患者病程长,预后差,且无法通过临床特征将其与抗体阳性自身免疫性脑炎区分开来。
引文
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[2]Dizon A M,Samples K L,Kimball K J,et al.Paraneoplastic Anti-N-Methyl-D-Apartate-Receptor Encephalitis Associated With an Immature Teratoma[J].Clinical Ovarian and Other Gynecologic Cancer,2012,5(2):97-98.
[3]Graus F,Titulaer M J,Balu R,et al.A clinical approach to diagnosis of autoimmune encephalitis[J].The Lancet Neurology,2016:S1474442215004019.
[4]HozákováL,SlonkováJ,Blahutová?.Anti-NMDAR encephalitis as a serious adverse event probably related to yellow fever vaccination[J].Klinicka Mikrobiologie A Infekcni Lekarstvi,2018,24(1):17.
[5]Titulaer M J,Mccracken L,I?igo Gabilondo,et al.Treatment and prognostic factors for long-term outcome in patients with anti-NMDAreceptor encephalitis:An observational cohort study[J].The Lancet Neurology,2013,12(2).
[6]Kattepur A K,Patil D,Shankarappa A,et al.Anti-NMDAR limbic encephalitisa clinical curiosity[J].World Journal of Surgical Oncology,2014,12(1):256.
[7]Titulaer M J,Mccracken L,I?igo Gabilondo,et al.Treatment and prognostic factors for long-term outcome in patients with anti-N-Methyl-D-Aspartate(NMDA)receptor encephalitis:a cohort study[J].Lancet Neurology,2013,12(2):157.
[8]Huang Q,Wu Y,Qin R,et al.Clinical characteristics and outcomes between children and adults with anti-N-Methyl-D-Aspartate receptor encephalitis[J].Journal of Neurology,2016,263(12):2446-2455.