Costa Diogo, Sardoeira Ana, Carneiro Paula, Neves Esmeralda, Santos Ernestina, da Silva Ana Martins, Samões Raquel
Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Department of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
J Neuroimmunol. 2022 Apr 15;365:577824. doi: 10.1016/j.jneuroim.2022.577824. Epub 2022 Feb 10.
Despite the existence of well-established diagnostic criteria for autoimmune encephalitis, there are diseases capable of mimicking it. This study sought to retrospectively evaluate the reasons for testing and the final diagnosis of patients admitted to a Neurology ward tested for anti-NMDAR antibodies and estimate sensitivity and specificity of current diagnostic criteria. The threshold for testing was lower than that of the prevailing diagnostic criteria, and the proportion of autoimmune encephalitis mimics was high. Searching for alternative diagnoses is of pivotal importance in cases of autoimmune encephalitis suspicion, and diagnostic criteria may need expanding so that no autoimmune encephalitis is missed.
尽管自身免疫性脑炎已有成熟的诊断标准，但仍有一些疾病可能与之相似。本研究旨在回顾性评估因检测抗NMDAR抗体而入住神经内科病房患者的检测原因及最终诊断，并估计当前诊断标准的敏感性和特异性。检测阈值低于现行诊断标准，自身免疫性脑炎疑似病例的比例较高。在怀疑自身免疫性脑炎的病例中寻找其他诊断至关重要，可能需要扩大诊断标准，以免漏诊任何自身免疫性脑炎病例。
