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[儿童抗N-甲基-D-天冬氨酸受体脑炎的管理]

[Management of anti-N-methyl-D-aspartate receptor encephalitis in children].

作者信息

Zhong Jian-Min

机构信息

Department of Pediatric Neurology, Jiangxi Children's Hospital, Nanchang 330006, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jun;16(6):584-8.

Abstract

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a new category of severe, potentially treatable autoimmune encephalitis and can appear in patients of all ages, but more frequently in children. It is a highly characteristic syndrome evolving in five stages: the prodromal phase (viral infection-like symptoms), psychotic phase, unresponsive phase, hyperkinetic phase, and gradual recovery phase. The treatment for this disorder includes first-line immunotherapy (steroids, intravenous immunoglobulin, plasmapheresis), second-line immunotherapy (rituximab, cyclophosphamide), and tumor removal. Hereby the progresses, selections and shortcomings of the treatment protocols for this disease are introduced.

摘要

抗N-甲基-D-天冬氨酸受体(抗NMDAR)脑炎是一种新型的严重的、潜在可治疗的自身免疫性脑炎,可发生于各年龄段患者,但在儿童中更为常见。它是一种具有高度特征性的综合征,病程分为五个阶段:前驱期(类似病毒感染症状)、精神症状期、无反应期、多动期和逐渐恢复期。该疾病的治疗包括一线免疫疗法(类固醇、静脉注射免疫球蛋白、血浆置换)、二线免疫疗法(利妥昔单抗、环磷酰胺)以及肿瘤切除。在此介绍该疾病治疗方案的进展、选择及不足之处。

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