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[一名免疫抑制患者中并发抗 N-甲基-D-天冬氨酸受体脑炎的新型隐球菌性脑炎]

[Cryptococcal Encephalitis Complicating Anti-N-methyl-D-aspartate Receptor Encephalitis in an Immunosuppressed Patient].

作者信息

Liu Dongming, Xu Hongwei, Yi Fang

机构信息

Department of Geriatric Neurology,Xiangya Hospital,Central South University,Changsha 410008,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020 Jun 30;42(3):417-420. doi: 10.3881/j.issn.1000-503X.11472.

Abstract

Cryptococcal encephalitis is a fatal central nervous system infectious disease,whereas anti-N-methyl-D-aspartate(NMDA)receptor encephalitis(NMDARE)is an autoimmune syndrome associated with psychological symptoms,behavioural abnormalities,seizures,and dyskinesias.Despite their distinct pathologies and pathogenic mechanisms,both of them can lead to cognitive dysfunction and abnormal behaviors,although anti-NMDARE can also have mood and mental disorders as its core manifestations.A patient with nephrotic syndrome accompanied by both cryptococcal encephalitis and anti-NMDARE was treated in our center,which for the first confirmed that these two conditions could coexist in one patient.The underlying mechanism may be similar to that of anti-NMDARE after other infections.

摘要

隐球菌性脑炎是一种致命的中枢神经系统感染性疾病,而抗N-甲基-D-天冬氨酸(NMDA)受体脑炎(NMDARE)是一种与心理症状、行为异常、癫痫发作和运动障碍相关的自身免疫综合征。尽管它们的病理和致病机制不同,但两者均可导致认知功能障碍和异常行为,不过抗NMDARE也可将情绪和精神障碍作为其核心表现。我们中心收治了一名患有肾病综合征并伴有隐球菌性脑炎和抗NMDARE的患者,这首次证实了这两种病症可在同一患者中共存。其潜在机制可能与其他感染后抗NMDARE的机制相似。

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