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一名患有急性脑病和低钠血症患者的自身免疫性边缘叶脑炎

Autoimmune Limbic Encephalitis in a Patient with Acute Encephalopathy and Hyponatremia.

作者信息

Agarwal K A, Albertolle M, Tiru M

机构信息

Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, USA.

Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA.

出版信息

Case Rep Med. 2019 Oct 7;2019:9051738. doi: 10.1155/2019/9051738. eCollection 2019.

Abstract

Acute encephalopathy is a common clinical presentation for hospital admissions. Autoimmune encephalitis is a rare cause of encephalopathy which has increasingly been recognized over the last decade. The detection of various neuronal antibodies has helped diagnose these syndromes, but they have limited availability, mostly in the developed countries. We present a case of a middle-aged female presenting with memory impairment, gait disturbances, and hyponatremia. A clinical diagnosis of autoimmune limbic encephalitis was made based on faciobrachial dystonic seizures, SIADH, and MRI changes 10 days prior to autoantibody titer returned. Prompt treatment with steroids and intravenous immunoglobulin was started with improvement in her neurological symptoms. This case highlights the importance of considering autoimmune encephalitis syndromes in the differential diagnosis of patients with classical neurological presentations and prompt diagnosis and immunotherapy to improve neurological outcomes.

摘要

急性脑病是住院患者常见的临床表现。自身免疫性脑炎是一种罕见的脑病病因,在过去十年中其发病率日益增加。各种神经元抗体的检测有助于诊断这些综合征,但它们的可及性有限,主要在发达国家。我们报告一例中年女性病例,该患者表现为记忆障碍、步态障碍和低钠血症。在自身抗体滴度恢复前10天,根据面臂肌张力障碍性发作、抗利尿激素分泌异常综合征(SIADH)和磁共振成像(MRI)变化,临床诊断为自身免疫性边缘叶脑炎。立即开始使用类固醇和静脉注射免疫球蛋白进行治疗,患者神经症状有所改善。该病例强调了在经典神经症状患者的鉴别诊断中考虑自身免疫性脑炎综合征以及进行及时诊断和免疫治疗以改善神经预后的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3ac/6800970/4e4f6157215a/CRIM2019-9051738.001.jpg

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