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[自身免疫性炎性脊髓疾病的鉴别诊断]

[Differential diagnostics of autoimmune inflammatory spinal cord diseases].

作者信息

Oertel Frederike C, Scheel Michael, Chien Claudia, Bischof Antje, Finke Carsten, Paul Friedemann

机构信息

Experimental and Clinical Research Center, Max Delbrück Center for Molecular Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Berlin, Deutschland.

Neurocure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of health, Berlin, Deutschland.

出版信息

Nervenarzt. 2021 Apr;92(4):293-306. doi: 10.1007/s00115-021-01092-2. Epub 2021 Mar 25.

Abstract

Myelitis is an acute or subacute inflammatory syndrome of the spinal cord. Myelopathy, often used as a synonym and presenting with similar symptoms in clinical practice, can be caused by numerous, not primarily inflammatory etiologies and might also show a progressive disease course. Within the last decade the spectrum of autoimmune myelitis was significantly broadened as was the spectrum of diagnostic methods. Apart from the characteristic example of multiple sclerosis with short-length myelitis and neuromyelitis optica spectrum disorders with longitudinally extensive transverse myelitis, multiple rare but important differential diagnoses should also be considered. Magnetic resonance imaging and laboratory analyses of serum antibodies and cerebrospinal fluid are the most important diagnostic methods and are fundamental for rapid treatment decisions, subsequently with better prognosis. This article reviews representative diseases within the spectrum of autoimmune spinal cord diseases and their differential diagnoses.

摘要

脊髓炎是脊髓的一种急性或亚急性炎症综合征。脊髓病在临床实践中常被用作同义词,且表现出相似症状,它可能由多种并非主要为炎症性的病因引起,也可能呈现进行性病程。在过去十年中,自身免疫性脊髓炎的范围以及诊断方法的范围都显著扩大。除了多发性硬化这种具有短节段脊髓炎的典型例子以及视神经脊髓炎谱系障碍这种具有纵向广泛横贯性脊髓炎的情况外,还应考虑多种罕见但重要的鉴别诊断。磁共振成像以及血清抗体和脑脊液的实验室分析是最重要的诊断方法,对于快速做出治疗决策至关重要,进而能带来更好的预后。本文综述了自身免疫性脊髓疾病范围内的代表性疾病及其鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6644/7992127/d1cfd9ff085a/115_2021_1092_Fig1_HTML.jpg

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