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抗N-甲基-D-天冬氨酸受体脑炎:一种严重的、潜在可逆转的自身免疫性脑炎。

Anti-N-Methyl-D-aspartate Receptor Encephalitis: A Severe, Potentially Reversible Autoimmune Encephalitis.

作者信息

Liu Cai-Yun, Zhu Jie, Zheng Xiang-Yu, Ma Chi, Wang Xu

机构信息

Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun 130021, China.

Department of Neurobiology, Care Sciences and Society, Karolinska Institute, 141 86 Stockholm, Sweden.

出版信息

Mediators Inflamm. 2017;2017:6361479. doi: 10.1155/2017/6361479. Epub 2017 Jun 18.

Abstract

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is potentially lethal, but it is also a treatable autoimmune disorder characterized by prominent psychiatric and neurologic symptoms. It is often accompanied with teratoma or other neoplasm, especially in female patients. Anti-NMDAR antibodies in cerebrospinal fluid (CSF) and serum are characteristic features of the disease, thereby suggesting a pathogenic role in the disease. Here, we summarize recent studies that have clearly documented that both clinical manifestations and the antibodies may contribute to early diagnosis and multidisciplinary care. The clinical course of the disorder is reversible and the relapse could occur in some patients. Anti-NMDAR encephalitis coexisting with demyelinating disorders makes the diagnosis more complex; thus, clinicians should be aware of the overlapping diseases.

摘要

抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎有潜在致命性,但它也是一种可治疗的自身免疫性疾病,其特征为显著的精神和神经症状。它常伴有畸胎瘤或其他肿瘤,尤其是在女性患者中。脑脊液(CSF)和血清中的抗NMDAR抗体是该疾病的特征性表现,由此提示其在疾病中的致病作用。在此,我们总结了近期的研究,这些研究已明确证明临床表现和抗体均有助于早期诊断和多学科治疗。该疾病的临床病程是可逆的,部分患者可能会复发。抗NMDAR脑炎与脱髓鞘疾病共存会使诊断更加复杂;因此,临床医生应了解这些重叠疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfbc/5494059/71c7a40a545f/MI2017-6361479.001.jpg

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