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自身免疫性脑炎罕见并发症的分析与讨论:两例报告

Analysis and discussion of the rare complication of autoimmune encephalitis: Two case reports.

作者信息

Li Rong, Jiang Li, Li Xiu-Juan, Hong Si-Qi, Zhong Min, Hu Yue

机构信息

Department of Neurology, Children's Hospital of Chongqing Medical University Ministry of Education Key Laboratory of Child Development and Disorders Key Laboratory of Pediatrics in Chongqing Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China.

出版信息

Medicine (Baltimore). 2018 Jul;97(27):e11202. doi: 10.1097/MD.0000000000011202.

Abstract

RATIONALE

Autoimmune encephalitis related to many antibodies against neuronal cell surface or synaptic proteins, it is increasingly recognized as the cause of a variety of neuropsychiatric syndromes.

PATIENT CONCERNS

The two pediatric cases were about autoimmune encephalitis with rare complication. One patient was a 11-year-old girl and was diagnosed with Voltage-Gated Potassium Channel complex (VGKC) antibody-mediated encephalitis with rhabdomyolysis; the other was also a 11-year-old girl and was diagnosed with anti- N-methyl-D-aspartate receptor (NMDAR) encephalitis.

DIAGNOSES

Both patients were diagnosed as autoimmune encephalitis with rare complication.

INTERVENTIONS

Intravenous methylprednisolone, oral prednisone and intravenous immunoglobulin was administered to both patients.

OUTCOMES

One patient was discharged after a half month's hospitalization; the other was finally with intestinal function failure, gradually developed multiple organ failure, and eventually died.

LESSONS

The pathogenic mechanism of autoimmune encephalitis associated with autoimmune disease is not fully understood, but may be related to a common immune pathological mechanism with variance in susceptibility caused by genetic or environmental factors.

摘要

原理

自身免疫性脑炎与多种针对神经元细胞表面或突触蛋白的抗体有关,它越来越被认为是多种神经精神综合征的病因。

患者情况

这两例儿科病例均为患有罕见并发症的自身免疫性脑炎。一名患者是一名11岁女孩,被诊断为电压门控钾通道复合物(VGKC)抗体介导的脑炎并伴有横纹肌溶解;另一名也是11岁女孩,被诊断为抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎。

诊断

两名患者均被诊断为患有罕见并发症的自身免疫性脑炎。

干预措施

两名患者均接受了静脉注射甲泼尼龙、口服泼尼松和静脉注射免疫球蛋白治疗。

结果

一名患者住院半个月后出院;另一名最终出现肠功能衰竭,逐渐发展为多器官功能衰竭,最终死亡。

经验教训

与自身免疫性疾病相关的自身免疫性脑炎的致病机制尚未完全了解,但可能与一种常见的免疫病理机制有关,遗传或环境因素导致易感性存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbe8/6076142/766721ba5dce/medi-97-e11202-g001.jpg

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